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Gaps in Oversight of Conflicts of Interest in Medicare Prescription Drug Decisions.

机译:监督医疗保险处方药决定中的利益冲突。

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摘要

Federal law and regulations require Medicare Part D Pharmacy and Therapeutics (P&T) committees to make prescription drug coverage decisions based on scientific evidence and standards of practice. Formulary decisions affect beneficiaries access to specific prescription drugs and the cost of drugs to beneficiaries and the Federal Government. To comply with the law, sponsors P&T committees must prevent conflicts of interest from influencing members to give preference to certain drugs. In addition, sponsors P&T committees must comply with Federal law and regulations that specifically address conflicts on P&T committees by requiring that at least one physician and at least one pharmacist on each committee be independent and free of conflict relative to the sponsor and pharmaceutical manufacturers. The objectives of this report were to: 1. To assess sponsors Pharmacy and Therapeutics (P&T) committees conflict-of interest-definitions. 2. To determine whether sponsors P&T committees established objective processes to determine and manage committee members conflicts of interest. 3. To determine whether the Centers for Medicare & Medicaid Services (CMS) oversee sponsors P&T committee compliance with conflict-of-interest requirements.

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