Prescription drugs and managed care: Can 'free-market détente' hold?

Health Affairs

Volumn 19, Issue 2, 2000, Pages 63-77

  Moran, Donald Will ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ADMINISTRATIVE PERSONNEL; ARTICLE; COST CONTROL; DRUG COST; DRUG INDUSTRY; ECONOMICS; FINANCIAL MANAGEMENT; HEALTH CARE QUALITY; HEALTH INSURANCE; HEALTH PERSONNEL ATTITUDE; HUMAN; INSURANCE; LEADERSHIP; ORGANIZATION AND MANAGEMENT; POLITICS; PRESCRIPTION; PSYCHOLOGICAL ASPECT; PUBLIC RELATIONS; QUESTIONNAIRE; SOCIAL CONTROL; STATISTICS; UNITED STATES;

ADMINISTRATIVE PERSONNEL; ATTITUDE OF HEALTH PERSONNEL; COST CONTROL; DRUG COSTS; DRUG INDUSTRY; FACILITY REGULATION AND CONTROL; HUMANS; INSURANCE BENEFITS; INTERINSTITUTIONAL RELATIONS; LEADERSHIP; MANAGED CARE PROGRAMS; MARKETING OF HEALTH SERVICES; POLITICS; PRESCRIPTIONS, DRUG; PRIVATE SECTOR; QUALITY OF HEALTH CARE; QUESTIONNAIRES; UNITED STATES;

EID: 0034146807     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.19.2.63     Document Type: Article

References (9)

1. D. Moran, "HMDs, Competition, and the Politics of Minimum Benefits," Milbank Quarterly (Spring 1981): 190-208.
2. Those industry leaders, together with those interviewed, are hereby anonymously thanked for their assistance, even as they are hereby absolved of any responsibility for the author's findings and conclusions.
3. "Idea of Having Medicare Pay for Elderly's Drugs Is Roiling the Industry," Wall Street Journal, 19 February 1999, A1.
4. While HMOs typically establish their own coverage policies and benefits management rules, the task of administering these benefits is commonly subcontracted to PBM firms, which specialize in drug benefits administration and can aggregate purchasing power across plans to obtain substantial rebates from manufacturers.
5. One important data-comprehension issue here is that many plans roll up certain classes of outpatient prescription drugs, such as oncology drugs, in "medical expense" rather than "prescription drug benefits." See "Co-payments Rise for Prescriptions," Wall Street Journal, 12 January 1999, B1.
6. "Office Visits Result in Prescriptions for Drugs," Drug Benefit Trends 10, no. 9 (1998): 10-11.
7. D. Thornton, "Health Plans and Coverage of Prescription Drugs," Health Plan (Nov/Dec 1998): 77-78.
8. D. Moran, "Federal Regulation of Managed Care: An Impulse in Search of a Theory?" Health Affairs (Nov/Dec 1997): 7-21.
9. N. Lavrac et al., "Intelligent Data Analysis in Medicine and Pharmacology: An Overview," in Intelligent Data Analysis in Medicine and Pharmacology, ed. N. Lavrac et al. (Dordtrecht, The Netherlands: Kluwer Academic Publishers, 1997), 4-7.