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Best Practices
PPC has developed a series of best practices materials including Model Policies and supporting “Fast Facts”
background issue papers with facts and figures, discussion of legal and policy issues, examples of pilot projects
and early adopters, and resources for further research. Best practice materials strategically address issues and
industry practices that contribute to the high cost of prescription drugs in the United States.
Materials currently available:
- Pharmacy Benefit Managers (PBM) – PBMs manage the majority of pharmacy benefit programs in the country. How
do they work? How can states, employers and health plans insure that PBMs work for them, and that negotiated
rebates and cost savings are fully passed through to benefit consumers?
PBM Fast Facts |
PBM Model Policy
- Saving Medicaid Dollars Without Capping Prescriptions – Research is clear: caps on prescriptions hurts
patients and in the long run, doesn’t save money. What are some alternative policy options already in operation
around the country which save significant Medicaid dollars without affecting patient health?
Prescription Caps Fast Facts |
Prescription Caps Model Policy
- Disclosure of Clinical Trials – Shouldn’t consumers, providers and government programs know about important
information on the efficacy and side effects associated with prescription drugs? Policies to require disclosure
of clinical trials data.
Clinical Trials Model Policy
- Purchasing Pools and PDLs – States and employers are joining together in purchasing pools to leverage
better prices from the manufacturers. The most effective of these are combined with a Preferred Drug List (PDL).
What works, and how much can be saved?
Purchasing Pool Fast Facts | PDL and Generics Model Policies
- Addressing Fraud through a State False Claims Act - States are eligible to recoup millions of dollars for over-billing, improper marketing, pricing fraud, and failure to pass
through rebates if they have a False Claims Act.
False Claims Act Fast Facts | State False Claims Act Model Policy (from Taxpayers Against Fraud)
- Protecting Privacy in the Doctor-Patient Relationship – Is your doctor’s prescribing records
being used as drug marketing tool? A model policy based on the first in nation New Hampshire law regulating use of
prescription data.
Prescription Privacy Model Policy
- Reining in Excessive Prices – Are drug manufacturers gouging consumers with overpriced drugs?
There are several policy options that have been adopted by states. What are the legal and practical considerations
in developing policies to rein in drug costs?
Drug Prices & Spending Fast Facts
| Drug Pricing Legal Issues (PPT)
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