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The New Medicare Drug Benefit:  Potential Effects of Pharmacy Management Tools on Access to Medications

The New Medicare Drug Benefit: Potential Effects of Pharmacy Management Tools on Access to Medications

This report describes the pharmacy benefit management tools that will be available to private plans administering the new Medicare drug benefit, including formularies, the definition of categories and classes, and cost sharing requirements. The authors conclude that substantial flexibility given to plans to design management tools could have significant implications for beneficiaries’ access to needed medications and out-of-pocket spending.

Issue Brief (.pdf)