How caps on drug spending might actually work

The Senate’s drug pricing proposal includes a cap on how much Medicare beneficiaries pay out of pocket for drugs, and, according to a new analysis, it could save seniors a substantial amount of money.

As STAT’s Nicholas Florko reports, the change could save about $4,000 a year for beneficiaries with the highest drug bills, according to a paper published yesterday in the New England Journal of Medicine.

The proposal is to cap out-of-pocket spending at $3,100. Under the current system, seniors are responsible for 5% of their drug costs once they hit a threshold of about $8,000 in a year. But because there’s no cap on the dollar amount, patients who need the most expensive drugs can be left paying considerable sums.

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