Rx and Medicare: Common costs of prescription drugs

A pharmacists reviews a prescription with a patient.

The Centers for Medicare & Medicaid Services (CMS) reported in 2016 that doctors prescribed about $121 billion in prescription drugs paid for under Medicare Part D. This data was in 2014, the most recent year for which prescription drug cost information is available. That represents a 17% increase over 2013.1

The good news is that Medicare offers prescription drug coverage. When enrolling for Medicare, you will have two options, both of which are administered by private companies that are approved by Medicare:2

  • Option A) If you're on Original Medicare, you can sign up for a stand-alone Medicare prescription drug plan, also called Part D. You usually have to pay a monthly premium for Part D.
  • Option B) You can choose a Medicare Advantage plan, which covers both hospital and medical care, and typically includes prescription drug coverage. Some Medicare Advantage plans don't have a monthly premium.

Many commonly prescribed drugs are available as generics, which can be less expensive and are sometimes even available at no cost. They can be used to treat common chronic conditions, including heart disease, high blood pressure, diabetes and pain.

These were the most commonly prescribed drugs to Medicare beneficiaries in 2014, ranked top to bottom based on the number of prescriptions written for them:1

  • Lisinopril is a type of drug known as an angiotensin-converting enzyme (ACE) inhibitor. It is used to treat high blood pressure and heart failure and also to improve survival after a heart attack.3

  • Levothyroxine sodium is the synthetic version of a thyroid hormone. It is used to treat hypothyroidism, or underactive thyroid, as well as thyroid cancer.4

  • Amlodipine besylate is a type of drug known as a calcium channel blocker. It is prescribed to lower high blood pressure and prevent angina, or chest pain.5

  • Simvastatin is one of a group of drugs called statins, which lower cholesterol. Statins are prescribed to help reduce the risk of a heart attack, heart surgery, or stroke.6

  • Hydrocodone-acetaminophen might be better known by its brand names, which include Vicodin, Lorcet and Lortab. It is a combination of hydrocodone, a narcotic painkiller, and acetaminophen (brand name Tylenol) is an over-the-counter medicine used to treat pain and inflammation.7

  • Omeprazole is one of a group of drugs called proton pump inhibitors. These drugs, which reduce the amount of acid made in the stomach, are prescribed for gastroesophageal reflux disease, or GERD. During GERD, acid from the stomach flows backward, causing heartburn and possibly injuring the esophagus, the tube that connects the mouth to the stomach.8

  • Atorvastatin calcium is another cholesterol-lowering statin drug.9

  • Furosemide is a type of drug known as a diuretic, or water pill. It is used to treat high blood pressure and fluid retention caused by such medical problems as heart, kidney and liver disease.10

  • Metformin HCL helps control blood sugar levels in type 2 diabetes.11

  • Gabapentin is an anti-seizure medication used to treat people with epilepsy. It is also prescribed to relieve postherpetic neuralgia (PHN), the pain that can last for months or years after an attack of shingles. In addition, the drug is used to treat restless leg syndrome, a strong urge to move the legs when sitting or lying down.12

According to the prescription drug information provided by CMS, Medicare spent $282 million on the generic drug Lisinopril, which was prescribed to about 7.5 million people in 2014. By comparison, Medicare spent $3.1 billion on the brand-name drug Sovaldi, which was prescribed to 33,000 people. Sovaldi is used in combination with other drugs to cure hepatitis C.1

The amount you may need to pay for prescription medications may differ with different Medicare Part D drug plans. When choosing prescription drug coverage, some factors you will want to consider include what types of medication you need, whether those medications are included in your plan’s drug list, and if your pharmacy is in the plan network. It may make sense for you to shop around for a Medicare Part D plan that can help you to pay the lowest share of the cost of your prescription drugs.13

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