A drug benefit: the necessary prescription for Medicare

Given statistics about how much older Americans pay in drug costs, the question is how best to structure a prescription drug benefit, not whether one is desirable or necessary. Several key challenges exist: 1. eligibility, 2. affordability, 3. cost containment, 4. existing coverage, and 5. financing...

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Published in:Health affairs (Millwood, Va.) Vol. 18; no. 4; pp. 20 - 22
Main Author: Rother, J
Format: Journal Article
Language:English
Published: United States The People to People Health Foundation, Inc., Project HOPE 01-07-1999
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Abstract Given statistics about how much older Americans pay in drug costs, the question is how best to structure a prescription drug benefit, not whether one is desirable or necessary. Several key challenges exist: 1. eligibility, 2. affordability, 3. cost containment, 4. existing coverage, and 5. financing. The AARP is committed to working with leaders on both sides of the aisle, as well as the industry and health plans, to promote a reasonable, workable, and overdue plan.
AbstractList [...]those with individually purchased supplemental (Medigap) insurance that provides limited drug coverage (Plans H, I, and J), who already pay high premiums because of adverse selection, face premium increases that threaten the affordability of that coverage. The pharmaceutical industry should not object to a Medicare drug benefit that is administered in ways similar to other health plans, where pricing decisions are kept in the private sector or where private-sector prices are the standard for Medicare payments. Since PBMs usually limit access to some drugs, a choice of PBMs may be appropriate. [...]as in most health policy, the key challenge is financing.
Given statistics about how much older Americans pay in drug costs, the question is how best to structure a prescription drug benefit, not whether one is desirable or necessary. Several key challenges exist: 1. eligibility, 2. affordability, 3. cost containment, 4. existing coverage, and 5. financing. The AARP is committed to working with leaders on both sides of the aisle, as well as the industry and health plans, to promote a reasonable, workable, and overdue plan.
Author Rother, J
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/10425839$$D View this record in MEDLINE/PubMed
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References 10718041 - Health Aff (Millwood). 2000 Mar-Apr;19(2):270
10425838 - Health Aff (Millwood). 1999 Jul-Aug;18(4):7-19
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Snippet Given statistics about how much older Americans pay in drug costs, the question is how best to structure a prescription drug benefit, not whether one is...
[...]those with individually purchased supplemental (Medigap) insurance that provides limited drug coverage (Plans H, I, and J), who already pay high premiums...
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SubjectTerms Adverse selection
Associations
Beneficiaries
Cost control
Cost Control - legislation & jurisprudence
Drug Costs - legislation & jurisprudence
Drug stores
Drug therapy
Employers
Geriatrics
Government programs
Health care policy
Health insurance
Health maintenance organizations
Health policy
Health services
HMOs
Humans
Insurance coverage
Insurance, Pharmaceutical Services - legislation & jurisprudence
Interest groups
Medicaid
Medicare
Medicare - legislation & jurisprudence
Medicare Prescription Drug Improvement & Modernization Act 2003-US
Mental health
Mental health care
Pharmaceutical industry
Pharmacy benefit management
Prescription drugs
Prices
Private sector
Public policy
Reimbursement
Retirees
United States
Willingness to pay
Title A drug benefit: the necessary prescription for Medicare
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