Report: Impact of a Medicare Part D annual prescription drug cap on charitable patient assistance

This analysis, conducted by the PAN Foundation, examines the impact that a Medicare Part D out-of-pocket prescription drug cap would have on patient spending across our disease funds.

We also selected four disease areas to illustrate how a Part D cap would affect funds with different assistance amounts, funding levels, and patient needs.

Our analysis resulted in several findings:

  • The national need for patient assistance would remain high even with a Part D cap.
  • Many of PAN’s disease funds with insufficient funding and high patient need would require sustained or increased donor contributions to help Medicare beneficiaries with their out-of- pocket costs.
  • PAN could use any savings as a result of the Part D cap to increase the number of grants offered and serve patients with the most significant economic need.

Overall, the national need for charitable assistance would remain above what the PAN Foundation—or any of the independent charitable patient assistance organizations combined—could provide to patients with life-threatening, chronic, and serious illnesses. An annual limit on prescription drug costs in the Medicare Part D benefit is an important step forward but is unlikely to resolve larger challenges of patient access and affordability.