Spend & benefit design
Where is Medicare drug spend and benefit value 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 →
What are IRA-negotiated prices actually saving?
$9,141per fill, Stelara (ustekinumab)
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 soon
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)