Effects of a 3-Tier Pharmacy Benefit Design on the Prescription Purchasing Behavior of Individuals With Chronic Disease.

Objective: To evaluate the impact of 3-tier (copayment) pharmacy benefit structures on medication utilization behavior.

Methods: A pretest-posttest quasi-experimental design was employed. Chronic disease sufferers (N=8,132) from a health plan were classified into the following groups: (a) 2-tier copayment moving to a 3-tier structure, ("converting" group), (b) 2-tier staying in a 2-tier structure and, (c) 3-tier staying in a 3-tier structure.

Considerations for optimal management of patients with pulmonary arterial hypertension: a multi-stakeholder roundtable discussion.

A roundtable panel of national and regional managed care decision makers and providers met to discuss pulmonary arterial hypertension (PAH) and strategies for management. As a rare, complex disease with high economic costs and potentially devastating outcomes, PAH necessitates that managed care providers balance optimal care with efficient use of healthcare resources. PAH specialists are recognized by health plans as knowledgeable experts and integral partners in managing patients and resources.

The future of Medicare Part D drug plans--results from a roundtable discussion.

Background: The Medicare Prescription Drug, Improvement, and Modernization Act, signed into law in 2003, provided access to prescription drugs for elderly Americans. The Part D benefit continues to evolve. Changes in plan designs, the impact of the doughnut hole on beneficiaries, and increased cost shifting have the potential to hamper the future of the Part D benefit.

Health information technology--results from a roundtable discussion.

Background: Health information technology (HIT), notably e-prescribing and electronic health records (EHR), have the potential to improve the quality of care, reduce medication errors and adverse events, and decrease overall health care utilization and costs. However, the United States continues to lag behind other countries in the adoption and use of HIT.

Objective: To review the various issues surrounding the implementation of HIT in the United States and potential drivers that will influence the use of e-prescribing and EHR.

Medicare Part D-a roundtable discussion of current issues and trends.

Background: Medicare Part D was introduced with a goal of providing access to prescription drug coverage for all Medicare beneficiaries. Regulatory mandates and the changing landscape of health care require continued evaluation of the state of the Part D benefit.

Objective: To review the current state of plan offerings and highlight key issues regarding the administration of the Part D benefit.

Consumer attitudes and factors related to prescription switching decisions in multitier copayment drug benefit plans.

Objectives: To examine patient attitudes related to formulary medications and medication-related decision making in multitier copayment prescription drug plans.

Study Design: A cross-sectional retrospective analysis.

Methods: Data were collected via mail survey from a random sample of 25,008 members of a managed care organization.

Impact of multi-tiered pharmacy benefits on attitudes of plan members with chronic disease states.

Objective: To evaluate the effects of 2- and 3-tiered pharmacy benefit plans on member attitudes regarding their pharmacy benefits.

Methods: We performed a mail survey and cross-sectional comparison of the outcome variables in a large managed care population in the western United States. Participants were persons with chronic disease states who were in 2- or 3-tier copay drug plans.