Washington Matters: FTC Launches Probe of PBM Policies (Part 3)

In Other Legislative and Regulatory News

Drug Benefit Trends
Posted 06/15/2004

By Daniel B. Moskowitz
Washington, DC-based Journalist

Medicare managed care plans will receive an increase of just over 6.5% on average in per capita payments when the rates for 2005 are announced in May, according to a preliminary estimate from the CMS. Those new rates–for which half of the payment will be based on the health status of the enrollee, a factor that accounts for only 30% of the payment this year–are expected to lead plans to lower premiums for members and to enrich the benefit packages they offer. . . .

CMS announced on April 1 rules for drug company reporting on the average sales prices of drugs administered to Medicare beneficiaries in physicians' offices. The first of the reports, required under last year's Medicare act, was due April 30, with additional data to be furnished every 90 days. CMS says that companies, when calculating the average sales prices of the drugs, must include volume discounts, prompt pay discounts, cash discounts, chargebacks, and rebates. For any piece of information not available by the quarterly deadline, manufacturers are to take the totals for the most recent 12 months for which they have the figures and divide them by 4. . . .

Illinois Gov Rod Blagojevich persuaded Walgreens to join a state program intended to help seniors afford prescription drugs. By adding its 457 Illinois stores to the program, Walgreens upped the total participating outlets by more than 25%. Although the program is set up to allow pharmacies to pick any of 4 levels of discounts, most have chosen the lowest level (12% off brand-name drug prices and 35% off generic drug prices) or, like Walgreens, the deepest discounts (15% off brand-name drug prices and 50% off generic drug prices). . . .

Drug Benefit Trends 16(5):236-239, 2004.

© 2004 Cliggott Publishing, Division of CMP Healthcare Media
Copyright © 1994-2004 by Medscape.

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