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Case
Study
Explaining
and Defending the Medicare Part D Program
Situation:
Industry
representatives needed help responding to proposals that would have repealed the
non-interference provisions of the new Medicare Part D outpatient prescription
drug benefit.
Actions:
Researched
and wrote white papers, talking points and related materials explaining the
substance of Medicare Part D’s non-interference provisions in language
appropriate for various stakeholder groups.
These documents included information about how repealing the provisions
would not produce cost savings unless Medicare also created a restrictive
national formulary that would limit patient’s access to specific medicines.
These documents also addressed the mischaracterization of the
Department of Veterans Affairs (VA) pharmaceutical procurement and pricing
system as “negotiations” between the government and pharmaceutical
companies.
Analyzed the proposed set of drug classes and categories developed by the
United States Pharmacopeia as
guidance for companies developing Part D formularies.
Organized meetings with Veterans
advocacy organizations to educate them about how changes to the Medicare Part
D program could negatively effect Veterans’ health care.
Wrote the “Veterans
Healthcare Administration - Pharmaceutical Price Control and Rationing System”
white
paper to explain the relationship
between the Medicare Modernization Act and the VA pharmacy system, and presented
this paper to a group of economists.
Outcome:
Industry representatives used these documents to clearly and simply
explain the substance of Medicare Part D’s non-interference provisions,
and to oppose the legislative repeal of these provisions.
Engaged economists interested in the implications of the MMA so they would be more
involved in
this policy debate. Specifically, they were better able to analyze and
communicate the economic implications of the legislative proposals because
they had a better understanding of the nuances and
implications of the non-interference provisions, how these provisions related to the
Veterans Affairs pharmaceutical purchasing system, and how Medicare Part D was
a system created to provide drug benefits rather than specific medicines.
Activated Veterans’ organizations to become more engaged in opposing the repeal of the
non-interference provisions because they understood the risks this could have
for to the VA
healthcare system.
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