Part D formulary guideline changes proposed

The U.S. Pharmacopeial Convention suggests adding some specific vaccine types to guidelines on Medicare drug lists.

By David Glendinning, AMNews staff. Dec. 11, 2006.

Washington -- The group that advises Medicare drug plans on what medications to cover is seeking advice from physicians and others on how to adjust those recommendations for 2007.

The U.S. Pharmacopeial Convention has proposed several additions, deletions and clarifications to its drug formulary guidelines and will accept public comments on the new list. The guidelines do not mention any medications by name but include drug therapeutic categories, pharmacological classes and "formulary key drug types."

Medicare drug plans are not required to follow the guidelines when crafting their approved drug lists, but those that cover at least two medications in each category or class, as well as at least one drug of each key type, will get less scrutiny from federal officials when it comes time to approve the formularies.

Most changes that USP has proposed involve additions to the formulary key drug types. Instead of just covering "vaccines," for instance, the group is now encouraging plans to cover specific ones, such as "vaccines to prevent meningococcal disease."

In other areas, the guidelines are less specific. Instead of listing oral and parenteral bisphosphonates as separate key types, for example, USP is proposing putting all bisphosphonates under a single type.