MINDS MEETING ON OUTPATIENT DRUG BENEFIT IN MEDICARE

Pharmaceutical Research and Manufacturers of America and Senator David Pryor appear to be getting closer to agreement on Medicare outpatient drug benefits, as Sen Pryor's two amendments to the Senate Finance Committee are seen to be "remarkably close, in their basic outlines, to the two most prevalent industry approaches to recent Capitol Hill health care reform markups," the Pink Sheet says.

One of Sen Pryor's amendments is for a fee-for-service plan as has been proposed in the Clinton Health Security Act, which also provides concessions to innovator companies. This includes proposals for a flat 17% rebate on single-source products and a generic rebate of 10% where the generic's average manufacturer price was more than 50% of that of the brand-name product.

His second option is a hybrid of managed care incentives, the Pink Sheet notes; a "drug benefit carrier (pharmacy benefit management) approach and fee-for-service. It would allow the elderly to select from three options: they could enroll in Medicare HMOs; they could elect to receive medicines through approved drug benefit carriers; or they could receive drug coverage through a fee-for-service program administered through the Health Care Financing Administration.