Broad Medicare Formularies Would Negatively Impact Rx Industry, PCMA Says
This article was originally published in The Pink Sheet Daily
Limiting PBMs’ ability to control costs in Medicare Rx would benefit advocates of a government-run health care system, Pharmaceutical Care Management Association CEO Merritt says. Broad drug formularies also would increase costs for employers, he says.
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Companies will accept the government subsidy for retirees’ drug coverage initially, but will move former workers to the Medicare drug benefit in later years, executives from Kaiser Foundation Health Plans and the Employers Coalition on Medicare predict.
U.S. Pharmacopeia is aware of speculation that it will elevate the “recommended subdivisions” in its draft guidelines to classes in the final model, but says it has not made a decision and that its expert committee is still discussing the issue.
The proposed total is greater than the number of classes desired by PBMs but falls below the threshold drug manufacturers are seeking. Medicare Part D plans following the model formulary would have to offer at least two drugs in each therapeutic category and pharmacologic class.