MediMedia Managed Markets
Managed Care


Managed Pharmacy

The Formulary Files
Krishna Rutvij Patel, PharmD

Evidence-based interventions to improve adherence have become a focus of formulary decision makers. Regimen simplification works — up to a point. Once-daily dosing only slightly improves adherence compared with twice-daily dosing, according to study in Clinical Infectious Diseases.

Contributing Voices

The vast majority of Part D plans follow a tiered cost-sharing structure with incentives for members to use less expensive generic and preferred brand-name drugs. Cost-sharing has increased since 2006, but the Kaiser Family Foundation reports in “Analysis of Medicare Prescription Drug Plans in 2011 and Key Trends Since 2006” that there was barely a change between 2010 and 2011.” The foundation reports that since 2006, median cost sharing for a 30-day supply of nonpreferred brand name drugs in stand-alone prescription drug plans (PDPs) increased by 42 percent, from $55 to $78. Preferred brand costs increased 50 percent, from $28 to $42. But since 2010, cost sharing has been stable.

About half of PDP enrollees and over 75 percent of MA-PD plan enrollees are in plans that charge 33 percent coinsurance for specialty drugs. Compared to 2009, this share is down modestly for PDPs but up substantially for MA-PD plans. In contrast, only 4 of the 35 national or near-national PDPs charged a 33 percent coinsurance rate for specialty tier drugs in 2006.

John Marcille
Thomas Reinke
Medication Management
Thomas Reinke
The Formulary Files
Formulary Management
Claudia Schlosberg, JD
Richard Stefanacci, DO
Bob Kirsch
Legislation & Regulation
John Carroll
Ed Silverman