The Medicare Drug Pipeline
Published February 2026 · 18 min read
Growing Fast
Drug spending's share of Medicare grew from 11.0% overall to 14.8% in 2023 — totaling $94.2B over the decade.
The Specialty Drug Revolution
Medicare drug spending is being driven by a handful of extraordinarily expensive specialty drugs. Aflibercept (Eylea), used for macular degeneration, is the single most expensive drug in Medicare — generating nearly $20 billion in payments over the decade. Cancer drugs, immunotherapies, and biologic agents make up the rest of the top tier.
Why It Matters
As drug costs grow faster than overall Medicare spending, they consume an ever-larger share of the program's budget. The Inflation Reduction Act's drug price negotiation provisions were designed to address this — but they only apply to a small number of drugs initially. The broader trend of specialty drug dominance shows no signs of slowing.