tci Medicare Compliance & Reimbursement - 2005 Issue 1

PRESCRIPTION DRUGS: More Drugs? Fewer Drugs? Formulary Debate Rages On

Health plans and pharmaceutical companies in high-stakes, big-dollar clash As the countdown proceeds toward the January 2006 launch of the full prescription-drug benefit, sparring continues over how wide a choice of medications a beneficiary will get in a Medicare private health plan or prescription drug plan.Some battles have a heavy tinge of the political, with various pharmaceutical-related constituencies looking to improve their credibility with the public and with policymakers as the true guardians of beneficiaries' health and/or taxpayers' wallets. For example, in a recent round, U.S. Pharmacopeia, which is developing model guidelines for drug formularies in...

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