Can Medicare Draw Lessons from Dutch Experience with a National Formulary?
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Joshua Cohen, PhD Senior Research Fellow, Tufts Center for the Study of Drug Development, and Senior Research Associate, Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands Cherie Paquette, AB Research Coordinator, Tufts Center for the Study of Drug Development Catherine Cairns, MPH Research Assistant, Tufts Center for the Study of Drug Development
Key Words Access; Cardiovascular drugs; Copayment tiers; Formulary; Medicare prescription drug benefit; Transparency Correspondence Address Joshua Cohen, PhD, Tufts Center for the Study of Drug Development, 192 South Street, Suite 550, Boston, MA 02111 (email: [email protected]). This paper was presented by Joshua Cohen at the Drug Information Association’s Annual Meeting, June 2005, Washington, DC. Continuing Education The Drug Information Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Drug Information Association designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™ . Physicians should only claim credit commensurate with the extent of their participation in the activity. The Drug Information Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program is designated for a maximum of 1 contact hour or .1 continuing education units (CEUs). 286000-07-402-H04. If you would like to receive a statement of credit, you must review the article, answer the questions to the posttest on the Posttest and Evaluation Form and submit it to the Drug Information Association. Participants must receive a passing score of 80% or better on the posttest in order to receive a statement of credit. Statements of credit will be mailed within one month of receipt of the Posttest and Evaluation Form. There is no fee to receive your statement of credit.
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Can Medicare Draw Lessons From Dutch Experience With a National Formulary? Objective: Using seven therapeutic subclasses of cardiovascular drugs as a case study, we investigated how different systems of formulary practice have an impact on access to prescription drugs, as well as the likely repercussions of the recently passed Medicare legislation on Medicare beneficiaries. We identified four dimensions of access: availability, coverage, equity, and flexibility. We examined a fifth item, transparency, unrelated to access but relevant to the formulary decision-making process as a whole. Study Design and Methods: Drawing from public data from the US and Dutch drug regulatory agencies, three leading US managed care plans participating in the Medicare Advantage program, Michigan’s Medicaid agency, and the Dutch board of insurers, we determined for the period 1991–2004 (1) which cardiovascular drugs were approved for marketing in the United States and the Netherlands and approval dates; (2) formulary status of the approved drugs; and (3) copayments for on-formulary drugs. For each insurer, we dete
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