Medicare negotiations

In the near future, government policies may be less supportive of the pharmaceutical industry than in the past. In the Bush administration, Secretary of Health and Human Services Michael Leavitt and FDA Commissioner Andrew von Eschenbach opposed federal efforts to negotiate lower prices for Medicare prescription drugs and to allow reimportation of prescription drugs at lower prices. In the Obama administration, Secretary of Health and Human Services Kathleen Sebelius, FDA Commissioner Margaret Hamburg, and FDA chief deputy Joshua Sharfstein will likely change these policies. New laws and policies may do more to favor consumers. 

Under the Medicare Prescription Drug Improvement and Modernization Act 2003 (use 2003), however, the U.S. government was specifically prohibited from using its bulk buying power for Medicare beneficiaries to negotiate medicines prices on cost-effectiveness grounds. Section 1123 of the legislation also commissioned a study by the USDoC. 

Direct claim. The plan member pays for the prescription at the pharmacy, then submits a claim form for reimbursement. This was the most common method before the use of electronic claim submissions. Discount prescription card system. Plan members are issued a card or coverage document to be presented at the pharmacy when a prescription is filled. The member pays 100% of the negotiated discormt-ed cost of the prescription. This method has become more popular with Medicare eligible patients who do not currently have prescription drug coverage, but join or purchase a card program from a third-party organizahon such as AARP or the manufacturer. 

One of President Obama s main proposals dirring the presidential campaign was to let the US Federal govermnent negotiate Medicare drag prices. This... 

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