ISPOR Comments on the Medicare Rx Data Elements
Intro by Bradley Martin PharmD, PhD, RPh, Associate Professor
and Head of the Division of Pharmaceutical Evaluation and
Policy,
College of Pharmacy University of Arkansas for Medical Sciences,
Little Rock, AK, USA
In December 2003, Congress enacted the Medication
Prescription Drug, Improvement, and Modernization Act of 2003,
which establishes a new Part D benefit that will provide
outpatient prescription drug coverage beginning in January 2006.
The Medicare Part D is a complex plan in which beneficiaries
will have deductibles, variable copays, a benefit gap or
“doughnut hole”, and catastrophic coverage. The Part-D benefit
will be largely administered by private prescription benefit
management (PBM) companies which will develop formularies and
negotiate rebates with manufacturers. This legislation offers
dramatic research opportunities for ISPOR members. Never before
has a single piece of legislation extended prescription coverage
to so many Americans, over estimated 37 million in 2006. One of
the limitations with using past Medicare data has been the
inability to link physician and hospital utilization with
prescription utilization for most beneficiaries. When Medicare
Part-D is implemented in January 2006, these prescription
utilization data will be collected by the Centers for Medicare
and Medicaid Services (CMS) from PBMs to calculate payments
under several different mechanisms. On January 31, 2005, ISPOR
was asked to provide input using researchers perspectives
regarding the types of information about prescription drugs use
that they would like to have available. ISPOR was given a
pre-decisional document describing the data elements that were
proposed to be collected for each prescription drug event (PDE)
record and the ISPOR retrospective database SIG members swung
into action providing comments to CMS in a very tight 28 day
deadline. Below and at the ISPOR website at:
http://www.ispor.org/sigs/Comments_MedicareRxDataElements.pdf, are the comments we offered to CMS regarding the prescription drug
event records organized in four categories. We are grateful that CMS
recognizes the research value of these data and are thinking beyond the
routine payment uses of these data to support important policy,
economic, and epidemiologic research applications of the data. We will
continue to work with CMS to help guide the development of these data
and to advocate on behalf of all ISPOR researchers to ensure Medicare
data can be used to support a broad spectrum or research activities
To view the ISPOR comments, see:
http://www.ispor.org/sigs/Comments_MedicareRxDataElements.pdf.
This was an initiative of the ISPOR Retrospective Database Special
Interest Group Database Development Working Group. |
