GAPS IN OVERSIGHT OF CONFLICTS OF INTEREST IN MEDICARE PRESCRIPTION DRUG DECISIONS

HHS: March 5, 2013

WHY WE DID THIS STUDY

Federal law and regulations require Medicare Part D Pharmacy and Therapeutics (P&T) committees to make prescription drug coverage decisions based on scientific evidence and standards of practice. Formulary decisions affect beneficiaries’ access to specific prescription drugs and the cost of drugs to beneficiaries and the Federal Government. To comply with the law, sponsors’ P&T committees must prevent conflicts of interest from influencing members to give preference to certain drugs. In addition, sponsors’

P&T committees must comply with Federal law and regulations that specifically address conflicts on P&T committees by requiring that at least one physician and at least one pharmacist on each committee be independent and free of conflict relative to the sponsor and pharmaceutical manufacturers. Read more