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Medicare Part D 2008 Data Spotlight: Utilization Management

This spotlight examines three common techniques used by stand-alone prescription drug plans to manage enrollees’ use of formulary drugs, such as quantity limits, prior authorization, and step therapy rules. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription drug plan choices.

It analyzes data from the 47 stand-alone prescription drug plans available nationwide using a sample of 169 commonly-used and high-cost prescription drugs. It finds that utilization management restrictions are more common in 2008 than in 2006, with 30% of sample drugs subject to some use restriction in 2008, up from 20% in 2006.

Each of the spotlights in this series were prepared by a team of researchers at Georgetown University, NORC and the Kaiser Family Foundation.

Data Spotlight (.pdf)