7 February 2019 - When Medicare prescription drug insurance was created in 2003, the idea that beneficiaries with very high drug costs should pick up 5% of the tab seemed reasonable - but that was well before specialty drugs were invented that carry price tags in the tens of thousands of dollars.

Today, the 5% coinsurance charge shouldered by Medicare Part D beneficiaries with serious illnesses does not look so reasonable. Instead, sky-high prices of specialty drugs threaten to bankrupt some enrollees - mainly because Part D does not cap the total amounts that enrollees must pay out of pocket each year.

A new report finds that Part D enrollees are exposed to thousands of dollars in out-of-pocket costs for drugs that treat cancer and other serious illnesses. Researchers at the Kaiser Family Foundation (KFF) studied expected annual out-of-pocket costs this year for 30 specialty drugs used to treat four conditions: cancer, hepatitis C, multiple sclerosis and rheumatoid arthritis. Median out-of-pocket costs ranged from $2,622 for Zepatier (for hepatitis C) to $16,551 for Idhifa (for leukaemia).

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