Abrupt removal of many drugs from Part D formularies is creating problems

May 19, 2008

A new report from Avalere Health has found that many drugs were dropped from CMS' 2008 Part D formulary files.

Medicare Part D drug plans have dropped many drugs from their formularies from 2007 to 2008, causing some disruption of care to beneficiaries. The plans have taken this action because the Centers for Medicare & Medicaid Services deleted more than 1,500 drug codes from its 2008 Part D Formulary Reference File, going from 7,100 to 5,500 drugs. These are some findings from a new report from Avalere Health. The report explained that the drugs were dropped because they were unapproved; discontinued; Part A or Part B products; had redundant codes; or were not reimbursable under statute, such as agents for cosmetic purposes. It concluded that the abrupt withdrawal of these drugs has created some patient care problems and recommended involving pharmacists and physicians in formulary decisionmaking.

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