Experiences Of Health Maintenance Organizations With Pharmacy Benefit Management Companies

On October 25,1999, the President directed the Secretary of Health and Human Services to study prescription drug costs and trends for Medicare beneficiaries. He asked that the study investigate: price differences for the most commonly used drugs for people with and without coverage; drug spending by people of various ages, as a percentage of income and of total health spending; and trends in drug expenditures by people of different ages, as a percentage of income and of total health spending. This report is the Department's response to that request. It represents the work of individuals and agencies throughout the Department, including the Agency for Healthcare Research and Quality (AHRQ), the Food and Drug Administration (FDA), the Health Care Financing Administration (HCFA), and the Office of the Assistant Secretary for Planning and Evaluation (ASPE).

How will the failures and findings of the past affect this fiercely debated current issue? In the near future, Congress may call for federal provision of outpatient prescription drugs as a benefit of the Medicare program. Prescription Drugs Under Medicare: The Legacy of the Task Force on Prescription Drugs is the story of the very first serious federal effort to study the feasibility of funding a drug benefits program for the elderly. That effort failed, and this fascinating text reveals why and how the program came to grief. Prescription Drugs Under Medicare explains the politics and practicalities of several government efforts to fund prescriptions for the elderly. The 1969 task force report is reprinted here in its entirety, along with comments from two of its primary architects, Dr. T. Donald Rucker and Dr. Philip Lee. Also included are excerpts from the report's review by the Dunlop Committee. The drug prices have changed, but the basic dilemma is the same. Prescription Drugs Under Medicare examines the burning issues, including: the reasons for the explosive growth in prescription prices from the 1950s onward the ongoing conflicts between the pharmaceutical industry and the government regulators the short-lived Reagan reforms of Medicare benefits the impact of managed care on the pharmaceutical marketplace Including powerful behind-the-scenes accounts, Prescription Drugs Under Medicare provides hard-to-find information and lucid analyses of this hotly debated subject. Pharmaceutical executives, medical economists, and policymakers will be fascinated by the story of how the stage was set for the congressional debates occurring in 2001.

Health Care Fraud: Enforcement and Compliance focuses on fraud and abuse issues involving health care providers as well as application of the laws governing fraud and abuse to manufacturers of drugs and medical devices and other non-providers such as medical researchers.

Managed Care Pharmacy Practice, Second Edition offers information critical to the development and operation of a managed care pharmacy program. The text also covers the changes that have taken place within the delivery of pharmacy services, as well as the evolving role of pharmacists.