Costs of 34 Medicare Drugs To Be Capped at $618 Until December

Medicare rebate program to cut out-of-pocket costs for certain Part B drugs from October through December.

Clipboard with green-colored paper listing types of Medicare coverage, and stethoscope on the side.
(Image credit: designer491, Getty Images)

Some people who take Medicare Part B drugs may save up to $618 per average dose from October through December, according to the Centers for Medicare & Medicaid Services (CMS).

Under the Medicare Prescription Drug Inflation Rebate Program, Part B beneficiary coinsurance may be lowered for 34 prescription drugs, which can mean savings of $1 to $618 per average dose, depending on individual coverage, CMS said.

“By reducing coinsurance for some people with Part B coverage and discouraging drug companies from increasing prices faster than inflation, this policy may lower out-of-pocket costs for some people with Medicare, and reduce Medicare program spending for costly drugs,” the agency said in a statement.

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The list of 34 drugs includes the blockbuster drug Humira, for treatment of severe rheumatoid arthritis, as well as Rybrevant, for treating lung cancer.

The news comes as many Americans struggle to pay for prescription medications.

“CMS, through the prescription drug law, continues to lower out-of-pocket drug costs for some people with Medicare by protecting them from sudden out-of-pocket cost increases when drug companies raise prices faster than the rate of inflation,” said Dr. Meena Seshamani, deputy administrator and director of the Center for Medicare.

When pricing rises faster than inflation

The rebate program is part of the Inflation Reduction Act signed into law last year. The law established Medicare Part B prescription drug inflation rebates for single source drugs and biologicals with prices increasing faster than the rate of inflation. It also established Medicare Part D prescription drug inflation rebates for certain drugs and biologicals with prices increasing faster than the rate of inflation.

CMS posts payment and rebate information quarterly for Part B rebatable drugs subject to the coinsurance adjustment. The Part B drugs that are affected by the coinsurance adjustment may change quarterly, the agency said.

The news comes on the heels of the CMS announcing the first 10 Medicare Part D drugs selected for talks with drugmakers on lowering costs.These discussions are set to take place later this year and carry over into 2024, with the negotiated rates taking effect in 2026.

The 10 drugs covered in the talks are: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara and Fiasp/NovoLog. They accounted for $50.5 billion in total Part D covered prescription drug costs from June 2022 to May 2023, CMS said.


Joey Solitro

Joey Solitro is a freelance financial journalist at Kiplinger with more than a decade of experience. A longtime equity analyst, Joey has covered a range of industries for media outlets including The Motley Fool, Seeking Alpha, Market Realist, and TipRanks. Joey holds a bachelor's degree in business administration.