tci Medicare Compliance & Reimbursement - 2004 Issue 4

Medicare Rx: REALITY: MEDICARE MAY NEED TO SET SOME Rx PRICES

Health economist Joseph Newhouse predicts that the Medicare prescription-drug law's "non-interference clause," which prohibits the federal government from using its clout to achieve lower drug prices, is unlikely to last long. The language - for which pharmaceutical manufacturers fought hard - "will be modified at some point," said the Harvard University economist and Medicare Payment Advisory Commission member at a Jan. 8 forum sponsored by Health Affairs. For most drugs, the law sets up a market-pricing system that likely will persist, says Newhouse. Most drugs have either generic or other brand-name competitors, and for those products, private...

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