Resources for Medicare Beneficiaries: Using Your Medicare Drug Plan | What to Do if Your Medicine Isn’t Covered
This 12-page publication helps Medicare Part D recipients and caregivers understand some of the challenges involved in navigating the Medicare prescription drug system, such as:
- How to request coverage of medication under a particular Medicare plan;
- When to appeal if a Medicare plan denies coverage of a particular medication;
- How to determine who will serve as an appointed representative;
- The steps to follow in the appeal process.
This brochure includes a sample letter of appeals for Medicare beneficiaries. A Spanish version also is available.
E.V.I.dently May 2013
Message From NPCThe Role of Pharmaceuticals in Health Insurance ExchangesOne of the most pressing issues in the implementation of the Affordable Care...
A Look at Rx Coverage and Cost in the New Health Insurance Exchanges
National Pharmaceutical Chief Science Officer Dr. Robert Dubois will lead a panel discussion, "Capturing the Value of Pharmaceuticals--A Look at Rx...NPC Welcomes Dr. Bryan Luce as PCORI Chief Science Officer
The National Pharmaceutical Council today welcomed the news that the Patient-Centered Outcomes Research Institute (PCORI) has appointed its first...Evidence, Coverage and Incentives: Challenges in Personalized Medicine
Personalized medicine is greatly changing the way medicine is practiced, as well as how drugs and biologics are developed. Today patients are...
Study Quantifies Impact of Pharmaceuticals on Enhanced Productivity
(WASHINGTON, DC, August 1, 2012)–The costs to employers of chronic health conditions on employee productivity are well documented, but few studies...New Report Urges Employers, Researchers and Policy Makers to Rethink How They Measure Health Care Results
San Francisco, CA & Washington, DC (February 28, 2011) -- Understanding the full value of improved health, including improvements in workforce...NBCH eValue8™ Report Reveals Health Plans’ Ability to Align Employee Incentives to Improve Health
Washington, DC (November 30, 2009) – The current rate of health care cost increases are unsustainable and health care purchasers are increasingly...NPC Board of Directors Elects Pfizer's Marie-Caroline Sainpy as Chairman
Washington, DC (October 27, 2009)--The National Pharmaceutical Council’s Board of Directors today announced that it has elected Marie-Caroline Sainpy...
Framework Helps ACOs Leverage Pharmaceuticals to Realize Quality, Cost Goals
Medications are more than an item on the balance sheet for health care providers. Pharmaceuticals offer a route to manage costs while achieving...What Will 2011 Hold for CER and PCORI?
When future historians consider health care, they may well look back on 2010 as a watershed year in America. The issues and events that occurred last...NPC Reflects on Changes in 2010
It’s been a year of great change not only for the biopharmaceutical industry, but for the National Pharmaceutical Council as well. With these changes...Congress Looks at Public vs. Public-Private CER Entity
As part of the ongoing congressional health care reform debate, there are several competing proposals regarding the creation of a comparative...
How Do Payers Consider Individual Treatment Effects?
Dr. Robert Epstein, former chief medical officer and senior vice president of medical affairs at Medco Health, explains that heterogeneity, or...Comparative Effectiveness Research in Medicare Decision-Making
At the June 2011 Drug Information Association Annual Meeting, NPC asked Dr. Marcel Salive for his thoughts on how comparative effectiveness research...Value-Based Insurance Design
National Pharmaceutical Council President Dan Leonard discusses a new report on Value-Based Insurance Design (VBID) with Dr. A. Mark Fendrick, Co-...A Look at Rx Coverage and Cost in the New Health Insurance Exchanges
National Pharmaceutical Chief Science Officer Dr. Robert Dubois will lead a panel discussion, "Capturing the Value of Pharmaceuticals--A Look at Rx...NPC Welcomes Dr. Bryan Luce as PCORI Chief Science Officer
The National Pharmaceutical Council today welcomed the news that the Patient-Centered Outcomes Research Institute (PCORI) has appointed its first...Evidence, Coverage and Incentives: Challenges in Personalized Medicine
Personalized medicine is greatly changing the way medicine is practiced, as well as how drugs and biologics are developed. Today patients are...Research
Formulary Limitations and the Elderly: Results from the Managed Care Outcomes Project
According to this article, the elderly are at partic
Why the Elderly Need Individualized Pharmaceutical Care
A “one drug fits all” approach does not work for eld
Coordinated Pharmaceutical Therapy in Chronic Care: Five Innovative Programs (Executive Summary)
Numerous studies indicate the limitations of a compo
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Commentary & Testimony
Framework Helps ACOs Leverage Pharmaceuticals to Realize Quality, Cost Goals
What Will 2011 Hold for CER and PCORI?
NPC Reflects on Changes in 2010
Congress Looks at Public vs. Public-Private CER Entity
NPC Submits Testimony on Draft CER Definition, Criteria and Framework