I will point out that the provisions for the Inflation Reduction Act should help decrease Meicare covered prescription drug costs starting in 2024. (Not so for those of us on ACA.) Here’s an article about how those costs will change How Will the Prescription Drug Provisions in the Inflation Reduction Act Affect Medicare Beneficiaries? | KFF
Edited to add:
I would also suggest using singlecare to price shop, in addition to GoodRx
AJ
Thanks but no impact expected on donut hole and Jardiance until at least 2025. Meanwhile Jardiance list price raised to $635/mo.
Maybe. At $635/month, a 12 month supply of Jardiance is actually over the catastrophic limit of $7400 for 2023. Per the article:
Caps Medicare beneficiaries’ out-of-pocket spending under the Medicare Part D benefit, first by eliminating coinsurance above the catastrophic threshold in 2024 and then by adding a $2,000 cap on spending in 2025. The law also limits annual increases in Part D premiums for 2024 to 2030 and makes other changes to the Part D benefit design. Under current law, the catastrophic threshold is based on the amount beneficiaries themselves pay out-of-pocket plus the value of the manufacturer discount on the price of brand-name drugs in the coverage gap phase.
If you can manage to time it correctly to get 13 monthly prescriptions filled in 2024 (first in early Jan and last in late Dec), you should be able to get one month free in 2024.
AJ
I don’t put much value on a $2000 cap. The current one is $4600.
My copay for Jardiance with my insurance is $1000/yr. But that seems high compared to the $6K I’m paying in premiums and 30 years of contributions to the Medicare from payroll and employers match.
This pricing is outrageous!!!
My point was at the price you quoted for Jardiance, it will put you over the catastrophic cap for 2024.
AJ
I’m delighted to read that Jardiance is one of the 10 drugs selected for negotiated prices under Medicare. A giant step forward, we hope.
Great medication, but expensive. It does work.