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This chartpack provides 2003 and 2006 estimates of total and out-of-pocket prescription drug spending by Medicare beneficiaries. The data and analysis for this chartpack, prepared by Actuarial Research Corporation, assume no change in current law. Chart Pack
The Kaiser Commission on Medicaid and the Uninsured has been monitoring the development of the Pharmacy Plus waiver initiated by the Bush Administration in 2002 and tracking the states that have pending or approved plans. The Commission has developed some materials describing the initiative, examining the financing mechanism, and discussing the implications for the Medicaid program and participating states. The Pharmacy Plus initiative allows states to secure federal Medicaid matching funds for prescription programs for…
This policy brief describes Pharmacy Plus waivers being considered by some states for their Medicaid program and their implications for Medicaid financing. These waivers offer an opportunity for prescription drug coverage for low-income seniors, but they also include a major change in the financing of care for all seniors on Medicaid -- a cap on federal Medicaid funding for all services provided to seniors on Medicaid. Policy Brief
This fact sheet, updated in April 2003, profiles current sources of prescription drug coverage among the Medicare population, describes the characteristics of beneficiaries who lack drug coverage and the implications of being without such coverage, and provides current data on prescription drug use and spending. Fact Sheet (.pdf)
This report details the rules governing prior authorization programs and the major steps in a model process based on key issues raised by beneficiary advocates, provider groups and states. Report
This report is a case study of five states' (California, Georgia, Oklahoma, Oregon, and Washington) implementation of prior authorization in their Medicaid programs. REPORT Download
Understanding how Medicare+Choice (M+C) plans manage their drug benefits may generate important lessons for Medicare. This report, based on interviews with both national and regional managed care firms, provides an in-depth look at how plans have managed their M+C outpatient pharmacy benefits in recent years. Findings show that plans rely on a number of cost management strategies to constrain the growth in drug spending including formularies, tiered-copayments, mail-order benefits, and fixed caps or dollar limits…
This article, which appears in the Food and Drug Law Journal, vol. 57, no. 3, 2002, pp. 423-444 was based on a report written by F.B. Palumbo and C.D. Mullins at the University of Maryland School of Pharmacy Center on Drugs and Public Policy and funded by the Kaiser Family Foundation. The article provides an historical overview and current U.S. Food and Drug Administration regulation of advertising prescription drugs directly to consumers. The article also…
This issue brief, prepared as part of the National ADAP Monitoring Project, examines ADAP formulary coverage of medications for the prevention and treatment of AIDS-related Opportunistic Infections across states, including trends in coverage and expenditures over time, and discusses some of the potential reasons for variations in coverage. For more information on the series see the National ADAP Monitoring Project page. Issue Brief
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