1 - The one exception was Medicare HMO coverage, which was identified through HCFA(now known as CMS) enrollment records.
2 -The MEPS estimates are adjusted for two reasons. First, the adjusted MEPS estimates can be directly compared to the MCBS estimates. Second, the unadjusted MEPS estimates would overstate the percentage of beneficiaries who have drug coverage.
3 - IMS Health data for 1996 indicate that about 33 percent of prescriptions are paid for fully in cash at the time they are filled.
4 - For each drug reported by a participant, MCBS must first establish exactly what drug was received and in what quantity. It then establishes, using First Data Bank data, an average wholesale price (AWP) for the specific drug. Finally, it must estimate the retail price charged for the prescription by applying a markup factor to the AWP. Factors vary according to the source of payment for the drug—cash, Medicaid, or other third party—and also according to the range of the wholesale unit price, because pharmacies tend to charge higher markups for drugs with a lower AWP.
5 - The difference in price estimates for beneficiaries with Medicaid is larger, because MCBS reduces prices to account for manufacturer rebates to states, while MEPS does not.
6 - This term includes any entity furnishing outpatient prescription drugs to noninstitutionalized individuals, including retail pharmacies, outpatient pharmacies within hospitals, HMOs, or other facilities, and mail-order suppliers.
"intro.pdf" (pdf, 23.11Kb)
"C1.pdf" (pdf, 75.87Kb)
"c2.pdf" (pdf, 169.02Kb)
"c3.pdf" (pdf, 92Kb)
"future.pdf" (pdf, 12.41Kb)
"appena.PDF" (pdf, 149.34Kb)
"appenb.pdf" (pdf, 27Kb)