A Balancing Act: The Politics of Formularies

Medicare Part D relies on formularies to keep costs down and delivery highquality care to beneficiaries. It also revives a long history of political pressure to keep formularies as open as possible.

Formularies are the active ingredient in the Medicare Part D benefit. The program relies on private-sector managed care plans to control prescription drug costs while delivering high-quality care to the Medicare population. The architects of Part D argue that managed care plans, using formularies, can do that much better than a program more directly administered by the federal government.

But there is no denying that the two views of formularies—as tools to ensure proper therapeutic selection, and as cost-containment mechanisms—can be in conflict.

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