Abstract
While much of the nation has been following the deliberations in Congress over a Medicare drug benefit, a quiet revolution has been taking place in the way benefits are managed for the 200 million Americans who already have insurance for prescription drugs. Just 10 years ago, most insured persons were required to make a standard copayment of $5 or less for a prescription, regardless of the type of medication they purchased. Now, incentive-based formularies are standard, with the amount of copayments depending on the type of drug prescribed; the contracts among the insurer, the manufacturer, and the pharmacy; and the . . .