Prescription Drug Benefits

Provides discussion and estimates of several Congressional proposals on prescription drug costs for Medicare beneficiaries.

U.S. Department of Health and Human Services

by Joseph A. DiMasi, Ph.D. Tufts Center for the Study of Drug Development Tufts University* A background report prepared for the Department of health and Human Services' Conference on Pharmaceutical Pricing Practices, Utilization and Costs August 8-9, 2000

by David H. Kreling, Ph.D., R.Ph. Sonderegger Research Center University of Wisconsin School of Pharmacy A background report prepared for the Department of Health and Human Services' Conference on Pharmaceutical Pricing Practices, Utilization and Costs August 8-9, 2000 Leavey Conference Center, Georgetown University

The Balanced Budget Act of 1997 included a number of changes to Medicare managed care. The newly created Medicare+Choice program differs from its predecessor with regard to payment policies, enrollment and disenrollment policies, and the types of plans that can contract to provide care to Medicare beneficiaries.

Executive Summary Prescription drugs play an ever-increasing role in modern medicine. New medications are improving health outcomes and quality of life, replacing surgery and other invasive treatments, and quickening recovery for patients who receive these treatments. As important as prescription drugs are, not everyone has access to them.

This report describes the experience of selected state governments in regulating provider-owned health care delivery systems that accept insurance risk for the provision or arrangement of health care services. We refer to these entities as Provider-Sponsored Organizations (PSOs).