The Kaiser Family Foundation hosted a March 14, 2005 policy workshop on the use of drug formularies in the private sector and their potential implications for beneficiaries under the new Medicare drug benefit, set to go into effect January 1, 2006. The workshop involved an expert panel, including perspectives from a health plan, a pharmacy benefits manager, a physician, the Centers for Medicare & Medicaid Services and policy experts.

Agenda (.pdf)

Presentation (.pdf)

Speaker Biographies (.pdf)

Resource List

Webcast and Transcript

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In connection with today’s workshop, the Foundation also released a number of new and updated reports and other resources.

• The Effects of Formularies and Other Cost Management Tools on Access to Medications: An Analysis of the MMA and the Final Rule, prepared for the Foundation by Jack Hoadley, Ph.D., of the Health Policy Institute at Georgetown University. This report examines the formulary provisions of the final Medicare regulations implementing the new drug benefit, and their implications for people with Medicare who enroll in new drug plans.
• A Comparison of Proposed and Final Regulations Governing Medicare Part D Plan Enrollment and Part D Benefit Appeal and Grievance Procedures, prepared for the Foundation by Sara Rosenbaum, J.D., of the George Washington University School of Public Health. This table highlights changes in the appeal and grievance procedures included in the proposed and final regulations implementing the drug benefit.
• The Medicare Prescription Drug Law — Fact Sheet. This Foundation fact sheet, updated this month, provides an overview of the new Medicare drug benefit.
• Medicare Modernization Act Implementation Timeline. This timeline, updated this month, presents important dates and deadlines for key implementation activities related to the new Medicare prescription drug benefit.
• Follow The Pill: Understanding the U.S. Commercial Pharmaceutical Supply Chain, prepared for the Foundation by Dan Mendelson and The Health Strategies Consultancy. The report describes the U.S. pharmaceutical supply chain, following prescription drugs as they move from manufacturers, to wholesale distributors, to pharmacies, and ultimately to patients. The report describes both the physical distribution of drugs through the chain, as well as the flow of money and the financial relationships among the key players.
• One State’s Medicaid Managed Care Formulary Operations: A Look at Pennsylvania, 2001-2002, prepared by Gene Bishop, MD, Clinical Assistant Professor of Medicine at University of Pennsylvania School of Medicine. The report examines formulary implementation under mandatory Medicaid managed care in Pennsylvania. Its findings are based on reports from sentinel prescribing physicians, interviews with participating pharmacists, and calls from Medicaid beneficiaries to a statewide legal services helpline.
• Cost Containment Strategies For Prescription Drugs: Assessing The Evidence In The Literature, prepared for the Foundation by Jack Hoadley, Ph.D., of the Health Policy Institute at Georgetown University. This report discusses and reviews various options to address prescription drug spending growth, including a description of each cost-containment strategy, its use by private or public payers, and a discussion of known evidence about its effectiveness or cost-saving potential.