More Than One in Five Medicare Seniors Hit $2,000 Drug Cap as Spending Rises
Health policy analysts are expressing concern over rising costs within Medicare's prescription drug program. In 2025, more than one-fifth of Medicare Part D enrollees reached the annual out-of-pocket cap of $2,000 for prescriptions, according to a report from congressional Medicare advisers. The Inflation Reduction Act has shifted some financial burden beyond this cap onto taxpayers and insurers while limiting seniors' costs. Spending in the catastrophic phase—where beneficiaries pay less after hitting their cap—accounted for 66% of total Part D drug spending last year, with GLP-1 drugs seeing a significant increase from $300 million to $2 billion. Cancer and diabetes treatments also experienced double-digit growth in costs. Experts suggest that while the Inflation Reduction Act provides incentives for cost control, it lacks sufficient tools after beneficiaries reach their cap. Medicare's prescription drug coverage is expected to contribute significantly to federal deficit projections over the next decade.
Tickers: $MRK
Topics: drug spending Inflation Reduction Act Medicare Part D enrollees