In this June 14, 2011 file photo, various prescription drugs on the automated pharmacy assembly line at Medco Health Solutions in Willingboro, N.J. A safeguard for Medicare beneficiaries has become a way for drugmakers to get paid billions of dollars for pricey medications at taxpayer expense, government numbers show. The cost of Medicare’s “catastrophic” prescription coverage jumped by 85 percent in three years, from $27.7 billion in 2013 to $51.3 billion in 2015, according to the program’s number-crunching Office of the Actuary. AP
A look at Medicare’s top 20 priciest prescription drugs in 2015, ranked by their cost above the program’s “catastrophic” coverage threshold.
Medicare’s catastrophic protection kicks in after a beneficiary has spent a given amount of their own money, $4,850 this year.
The beneficiary pays only 5 percent, while their insurer pays 15 percent, and taxpayers cover 80 percent. Catastrophic spending is a large and growing share of total costs, threatening to make Medicare’s popular prescription plan financially unsustainable.
Drug Name Uses Cost
Harvoni Hepatitis C $6.3 billion
Revlimid Cancer $1.7 billion
Sovaldi Hepatitis C $1.2 billion
Copaxone Multiple sclerosis $1.1 billion
Gleevec Cancer $1 billion
Humira Pen Rheumatoid arthritis $886 million
Tecfidera Multiple sclerosis $724 million
Renvela Kidney disease $675 million
Xtandi Prostate Cancer $633 million
Lantus Solostar Diabetes $633 million
Zytiga Prostate cancer $623 million
Enbrel Sureclick Rheumatoid arthritis $586 million
Abilify Mental illness $555 million
Sensipar Kidney disease $533 million
Truvada HIV $525 million
Aripiprazole Mental illness $504 million
Lantus Diabetes $484 million
Imbruvica Cancer $473 million
H.P. Acthar Multiple sclerosis $467 million
Lyrica Seizures $461 million
Some medications have additional uses.
Cost above catastrophic threshold in 2015; includes spending by taxpayers, insurers and beneficiaries.
Source: Centers for Medicare and Medicaid Services, Office of the Actuary
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