NYT: Advisory Panel Lists Drugs It Wants New (Medicare) Law to Cover

[DeepModem Mom]

Advisory Panel Lists Drugs It Wants New Law to Cover
By ROBERT PEAR

Published: January 4, 2005


WASHINGTON, Jan. 3 - A federal advisory panel, working closely with the Bush administration, announced a list of 146 types of prescription drugs on Monday that should be covered under Medicare's new drug benefit.

The panel, the United States Pharmacopeia, a venerable organization that sets standards for the pharmaceutical industry, said prescription drug plans should offer beneficiaries at least two drugs of each type. Insurers that follow the recommendations will be presumed to meet one of the major criteria in the new Medicare law....

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Under the law, officials will rely on private health plans to deliver drug benefits to the elderly and the disabled starting next year. The government will not establish a uniform list of drugs that must be covered. Rather, each plan will develop a list of drugs approved for reimbursement.

In general, drug companies want as many drugs as possible on each list, known as a formulary. Many doctors and consumer groups agree. But insurers and drug benefit managers generally want to limit the number and types of drugs. Otherwise, they say, the cost of the new drug benefit will soar out of control.

The guidelines issued on Monday, like a draft issued in August, juggle the competing concerns, but appear to come down in favor of the insurers more than the drug companies....


http://www.nytimes.com/2005/01/04/politics/04drug.html