Individuals enrolled in Medicare could soon pay just $2 for their prescription medication. The U.S. Centers for Medicare & Medicaid Services recently released a sample list of 101 drugs it intends to offer under the Medicare $2 Drug List Model, which would establish a low, fixed (up to $2 for a month’s supply) copayment for a standard Medicare-defined list of generic drugs. The program could start as early as January 2027.
The Medicare $2 Drug List Model was initially announced in response to President Biden’s Executive Order 14087, “Lowering Prescription Drug Costs for Americans.” It’s one of three models the Secretary of Health and Human Services proposed to improve prescription drug affordability and access. The other models focus on cell and gene therapy access and accelerating clinical evidence.
Here’s what Medicare recipients need to know about the preliminary list of $2 drugs.
Medicare $2 Drug List Model
Overall, the Medicare $2 Drug List Model is designed to “test whether a simplified approach to offering low-cost, clinically important generic drugs can improve medication adherence, lead to better outcomes and improve beneficiary and prescriber satisfaction with the Part D benefit.”
This new program could provide some relief for many Americans struggling to afford their prescription medication as costs rise. According to the ASPE, of the 4,200 drugs that increased in price between January 2022 and 2023, 46% had increases larger than the rate of inflation. This works out to be an average increase of 15.2%, or $590 per drug product. Additionally, the Kaiser Foundation found that in the past year, about three in ten adults reported not taking their medicines as prescribed because of the cost.
The sample drug list includes common medications across 15 clinical categories and is targeted toward common conditions among people with Medicare. It includes drugs such as penicillin, lithium, bupropion, escitalopram, and metformin, as well as plenty of other medicines for conditions like infection, diabetes and high cholesterol. A total of 35 drugs on the current list are for blood pressure and other cardiovascular issues.
However, the official list is still undergoing review as more feedback is obtained from various sources to create a list that “maximizes beneficiary access to low-cost generic drugs.” The U.S. Centers for Medicare & Medicaid Services are currently collecting input on the list through a Request for Information (RFI) (PDF).
This program builds on recent efforts to negotiate lower costs for Medicare drugs in general. In August, the Biden administration announced that it had reduced the price of ten drugs for those using Medicare Part D coverage.
