New Medicare Drug Data Reveals Costs & New Protections

New Medicare Drug Spending Data Reveals Rising Costs — and New Protections for Retirees

The federal government’s latest release of Medicare prescription drug spending data offers a rare, unfiltered look at where billions of dollars are going — and why recent policy changes matter more than ever for retirees.

The data, released by the Centers for Medicare & Medicaid Services (CMS), include:

An annual snapshot for 2024

A quarterly update for early 2025

Together, these datasets track spending across:

Medicare Part B, which covers physician-administered injectable drugs

Medicare Part D, which covers retail and mail-order prescriptions

For consumers, advisers and policymakers alike, the numbers confirm two realities at once: prescription drugs are enormously expensive at the system level — and recent reforms have dramatically reduced out-of-pocket risk for individuals.

Medicare Part B Drugs: Few Patients, Massive Spending

Part B drugs tend to serve relatively few patients but carry extremely high price tags. These are injectable therapies administered in doctors’ offices or outpatient clinics, often used to treat cancer or complex chronic conditions.

In 2024:

The highest-spending Part B drug was Keytruda, a cancer therapy, with roughly $6 billion in total spending.

The second-highest was Darzalex Faspro, another cancer drug, at about $2.5 billion.

While CMS highlights the top 10 drugs in summary charts, the full Part B dataset runs more than 3,000 rows deep, reflecting the wide range of therapies and manufacturers involved.

The data do not explain pricing mechanics, but they clearly illustrate how quickly costs escalate when advanced treatments are involved.

Medicare Part D Drugs: Where Most Beneficiaries Feel It

Part D tells a different story. These are the medications most Medicare beneficiaries recognize — including blood thinners, diabetes drugs and cholesterol treatments.

The 2024 Part D dataset contains nearly 27,400 rows, reflecting multiple manufacturers and reporting periods.

At the top of the list:

Eliquis, a blood thinner used by about 4.4 million people, generated $20.8 billion in total annual spending.

Other high-spending Part D drugs include Ozempic, Jardiance, Mounjaro, Xarelto and Trulicity — medications that are widely used, often essential and, in many cases, have limited alternatives.

Scale matters. Many beneficiaries take multiple prescriptions at once. Research consistently shows that the average Medicare beneficiary uses three to four medications, most of them generics.

The Part D Out-of-Pocket Cap Changes the Math

One of the most important takeaways from the data has little to do with total spending and everything to do with financial protection.

Under the Inflation Reduction Act, Medicare now caps annual Part D out-of-pocket spending. In 2026, that cap is $2,100.

Consider Dupixent, a drug used to treat asthma, eczema and other inflammatory conditions:

2024 total spending: about $1.8 billion

Roughly 65,000 users

Average annual cost: nearly $28,000 per person

Before the cap, patients could face tens of thousands of dollars in annual drug costs. Now, a beneficiary using a preferred pharmacy pays no more than $2,100 per year, regardless of the drug’s total price.

That shift fundamentally changes financial risk for retirees — especially those managing chronic or complex medical conditions.

What Medicare Drug Price Negotiations Will — and Won’t — Do

The federal government has also begun negotiating prices for a growing list of high-cost drugs. Those negotiations are expected to reduce overall Medicare spending, but they are unlikely to further lower individual out-of-pocket costs in the short term.

For beneficiaries, the spending cap already limits exposure. For Medicare itself, lower negotiated prices may help:

Slow premium increases

Reduce financial pressure across Parts B and D

That matters as healthcare costs continue to rise. Part B premiums increased nearly 10% year over year, and Part D premiums remain highly variable, with some plans doubling in price.

Why Consumers Should Look at the CMS Drug Data

CMS makes both Medicare drug datasets publicly available and searchable. Beneficiaries can:

Look up their own medications

See how widely those drugs are used

Understand their role in overall Medicare spending

The data won’t answer every pricing question. But they do provide transparency, context, and insight into how policy, coverage and cost intersect in retirement.

Key Takeaways

Medicare prescription drug spending reaches tens of billions of dollars, even for a small group of widely used medications.

Most beneficiaries take multiple prescriptions, magnifying system-wide costs even when individual copays are modest.

The Part D out-of-pocket cap dramatically reduces financial risk, especially for high-cost specialty drugs.

Drug price negotiations may help Medicare’s finances, even if individual spending is already capped.

Consumers can benefit from exploring CMS drug spending data to better understand their coverage and costs.