Follow the Dollar: Understanding Drug Prices and Beneficiary Costs Under Medicare Part D


This snapshot of the Medicare drug benefit supply chain by Avalere Health emphasizes that Medicare beneficiaries’ out-of-pocket costs are a product of negotiations that occur between many players and at multiple points along the supply chain. The report considers out-of-pocket costs as a whole – including cost-sharing via premiums, deductibles, and coverage gaps – not just the final price at the pharmacy counter. Flowcharts in the report illustrate at what point prices are negotiated and by whom.