Home Health Insurance News While Medicare Drug Price Negotiations Don’t Apply to Private Insurance, 3.4 Million People with Employer Coverage Take at Least One of the Selected Drugs

While Medicare Drug Price Negotiations Don’t Apply to Private Insurance, 3.4 Million People with Employer Coverage Take at Least One of the Selected Drugs

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While Medicare Drug Price Negotiations Don’t Apply to Private Insurance, 3.4 Million People with Employer Coverage Take at Least One of the Selected Drugs


In 2022, out of the 167 million individuals with employer-sponsored insurance, 3.4 million utilized at least one of the top 10 drugs designated for Medicare price negotiations, as reported by a new KFF analysis. Medicare anticipates releasing the negotiated drug prices, which are set to take effect in 2026, no later than September 1, 2024.

The most frequently prescribed drug for those with employer-sponsored health insurance was Jardiance, a medication used for managing diabetes and heart failure, with over 911,000 enrollees using it.

Looking ahead, the Medicare program will negotiate prices for additional medications, potentially affecting millions more individuals with employer coverage. Currently, the impact of reduced drug prices in Medicare on private insurance plans is not direct, and the indirect effects remain uncertain. Some experts contend that lower negotiated prices in Medicare could lead to increased prices in private insurance, whereas others argue that these Medicare prices may establish a benchmark, facilitating savings.

The complete analysis and further information regarding health costs can be found on the Peterson-KFF Health System Tracker, a dedicated online resource for monitoring and evaluating the U.S. health system’s performance.



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