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Beneficiary Cost-Sharing in Part D

A priority of OIG and HHS is to lower drug spending for people and programs. In Medicare Part D, as drug costs rise, the amount that beneficiaries pay out-of-pocket also increases. This amount—known as beneficiary cost-sharing—is not capped in Part D. As a result, some beneficiaries may have high out-of-pocket costs for their prescriptions. If beneficiaries' costs become unaffordable, they may skip doses of medication or forgo purchasing it altogether. This data brief will provide in-depth data on the amount beneficiaries pay out-of-pocket for Part D drugs. It will also determine the proportion of beneficiaries who have high cost-sharing and describe these beneficiaries and the drugs they commonly receive, including the proportion of drugs that are high cost.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
July 2020 Centers for Medicare and Medicaid Services Beneficiary Cost-Sharing in Part D Office of Evaluation and Inspections OEI-02-20-00460 2021