Drug spend & benefit economics
planned Benefit-level benchmarking from normalized CMS Landscape and Plan Benefit Package data is planned. Until then this hub covers Part D economics, the out-of-pocket cap, negotiated prices and modeled benefit pressure.
Where are Medicare drug economics and benefit pressures moving?
IRA out-of-pocket cap, deductible strategy, benefit-value trend.
How is the IRA out-of-pocket cap reshaping Part D benefit design?
$2,100OOP cap, CY2026
CY2026 final parameters
See the design shift →
How far are negotiated prices below the CMS list price?
$9,141below CMS comparison list price, Stelara
CY2026 negotiated prices (MFP)
See the drug list →
How fast is supplemental benefit value eroding?
-23.9%UHC vs 2022 baseline — modeled
Plan years 2022–2026 · modeled estimate
See the erosion →
Coming next
Where is Part D drug spend growing fastest by drug and prescriber?
Drug- and prescriber-level spend growth is on the public roadmap, arriving with the Part D PUF pipeline.
Planned CMS source: Part D Prescriber & Spending PUFs (annual)