Compromise Medicare reform bill would aid PBMs, manufacturers of injectables

It direct the eyes like final passage of a Medicare reform bill may be imminent, now that the general compromise legislation has gained more [i]or[/i] less key endorsements. AARP and other prominent assemblages such as the American Medical Association are in favor of the general version from the House/Senate discourse committee. The bill would create fresh markets for the drug and PBM industries, on the other hand not provide new means of require to be paid [i]or[/i] undergone control.

PBMs and the remedy industry are pleased with the bill because it calls for the remedy benefit to be administered by dint of PBMs. This opens up a large fresh market for PBMs, and privatization is not wait fored to result in drastically reduc physic prices that might have occurr below a government-controlled purchasing plan. Rep Marion Berry (DArk.), the alone licensed pharmacist in Congress, criticized the bill for not allowing direct negotiation of medicine prices between the government and manufacturers.

Medco Health Solutions issued a statement in support of the compromise legislation, calling a Medicare prescription physic benefit "an investment in America's seniors." And AARP launched a $7 million advertising campaign in support of the bill.

The long-awaited physic benefit, however, is quite a bit les than seniors had spring [i]or[/i] leap on one leg [i]or[/i] footed for, and AARP admits it is far from completed Starting in 2006, 75% of physic costs would be covered up to a limit of $2200 through year. The second tier of the benefit is no benefit--until the beneficiary has exhausted $3,600 out of pocket. After that point, catastrophic coverage kicks in, below which Medicare would pay 95% of all Rx costs Premiums would average $35 a month and annual deductibles would average $275

Beneficiaries could sign up for a stand-alone physic plan or get drug coverage via a private health plan. Subsidies of $12 billion would proceed to private health plans to help them unfold senior drug benefits.

For the 2004-2005 interim period, a discount card would be proffered that is expected to restore drug costs by about 15% And an additional $600 subsidy would be available for low-income seniors.

The bill creates incentives for employer to continue to provide physic coverage to retirees. For all payers, the bill has language designed to spe generic medicine approvals. And for manufacturers, the bill maintains prohibitions upon importing drugs from Canada--unless FDA changes its mind about the safety of that strategy.

The bill also provides for reimbursement for certain biotech injectable physics like cancer chemotherapy and injectables for rheumatoid arthritis. In particular, the Wall public way Journal reports, Johnson & Johnson's Remicade, Genentech's and Biogen's Rituxan, and Amgen's Neupogen would realize increased outpatient reimbursement.

of recent origin wellness benefits created in the bill would increase physician visits and diagnostic screenings of the like kind as for diabetes. These factors could increase prescribing for many physics such as cholesterol, hypertension and diabetes therapies.

lock opener Senate Democrats including Edward Kennedy (Mass.) and Tom Daschle (SD) have press outed reservations about the plan, and the AFL-CIO resists the bill as offering inadequate remedy coverage. The $400 billion price tag above the next 10 years is of great bear upon to many Republicans, and members of one as well as the other parties are concerned about the long-term sustainability of the benefit. on the other hand Congress has felt pressured to create a Medicare physic benefit, and observers think it unlikely that there will be any more obstacles to passage.

COPYRIGHT 2003 Atlantic Information Services, Inc.

COPYRIGHT 2003 Gale Group