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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.

Blog Post

#TBT: Alzheimer’s & Access to Health Information

As part of our “Throwback Thursday” blog series, we’re taking a look at a research topic that’s currently in the news and tagging it with...
Blog Post

NPC Asks CMS to Consider Patients’ Individual Treatment Effects In Part D Rulemaking

The National Pharmaceutical Council (NPC) today asked the Centers for Medicare and Medicaid Services (CMS) to consider maintaining “protected classes...
Commentary and Testimony Page

NPC Comments on CMS' Proposed Changes to Protected Classes

March 7, 2014Marilyn B. TavennerAdministratorCenters for Medicare & Medicaid ServicesU.S. Department of Health and Human Services200 Independence...
Blog Post

One Year Later: The FDA Safety and Innovation Act

We're pleased to share with you a guest post from Cynthia Bens, vice president, public policy, Alliance for Aging Research. It’s been a little over a...
Press Release

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...
Press Release

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...
Press Release

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...
Press Release

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...
Commentary and Testimony Page

NPC Comments on CMS' Proposed Changes to Protected Classes

March 7, 2014Marilyn B. TavennerAdministratorCenters for Medicare & Medicaid ServicesU.S. Department of Health and Human Services200 Independence...
Commentary and Testimony Page

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...
Commentary and Testimony Page

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...
Commentary and Testimony Page

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...
YouTube Videos

Can We Bring Clarity, Consistency and Transparency to Payer Coverage Decisions?

There is a bit of a "black box" around the formulary decision-making process. As a result, decisions about treatment access are often unpredictable...
YouTube Videos

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...
YouTube Videos

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...
YouTube Videos

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-...
Blog Post

#TBT: Alzheimer’s & Access to Health Information

As part of our “Throwback Thursday” blog series, we’re taking a look at a research topic that’s currently in the news and tagging it with...
Blog Post

NPC Asks CMS to Consider Patients’ Individual Treatment Effects In Part D Rulemaking

The National Pharmaceutical Council (NPC) today asked the Centers for Medicare and Medicaid Services (CMS) to consider maintaining “protected classes...
Blog Post

One Year Later: The FDA Safety and Innovation Act

We're pleased to share with you a guest post from Cynthia Bens, vice president, public policy, Alliance for Aging Research. It’s been a little over a...
Blog Post

NPC Webinar: Can We Bring Clarity, Consistency and Transparency to Payer Coverage Decisions?

Why are some treatments covered under a health care plan, while other treatments are not? How do payers evaluate the information needed to make...

Research

Transparency in Evidence Evaluation and Formulary Decision-Making

Although the type of evidence required to make healt

Blue Pill or Red Pill: The Limits of Comparative Effectiveness Research

By choosing "winners and losers," CER drug trials may leave patients who best respond to the "...

The Impact of Comparative Effectiveness Research on Health and Health Care Spending

This research illustrates some of the issues that must be addressed in applying the results of...

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Commentary & Testimony