Policy Primers: Public Coverage And Prescription Drug Pricing

Health Affairs has released the next set in a series of peer-reviewed health policy briefs on key issues currently shaping the prescription drug market. Each brief offers a short, accessible overview of the issue and a close examination of how it affects pricing.

This second set of briefs tell the story of different prescription drug coverage mechanisms (who pays whom and how much), how they interact with other pricing measures, and what future reforms might look like. They are:

MEDICARE PART B

The Medicare Part B “buy and bill” payment structure for physician-administered drugs also influences private-sector prices.

MEDICARE PART D

Medicare Part D covers retail prescription drugs for Medicare beneficiaries through unique, stand-alone drug insurance plans.

MEDICAID BEST PRICE

The Medicaid best price policy requires drug manufacturers to give Medicaid programs the best price among nearly all purchasers.

VETERANS HEALTH ADMINISTRATION

The Veterans Health Administration can often obtain very favorable prices for drugs and may be a model for Medicare and others.

These briefs are the result of a collaborative effort aimed at providing policy makers the tools they need to approach these issues, armed with concrete evidence and the latest research. The final set of policy briefs will be released in early fall. A longer overview of the series can be found in a recent post on Health Affairs Blog.

Health Policy Briefs are produced under a partnership of Health Affairs with the generous support of The Commonwealth Fund and Memorial Sloan Kettering Cancer Center.

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