Key Findings

1. Overall Trend: We examined whether differences in formulary coverage for commercial and Medicare plans changed over the past 15 months. Results showed that while there were no consistent trends over time across all the drug classes examined, certain drug classes developed important differences in 2007.
2. Medicare Advantage: For Statins, tier 1 and tier 2 access increased significantly on Medicare plans over the studied time period, as compared to commercial plans. Medicare plans exhibited a 15% greater overall tier 1/tier 2 status as compared to commercial plans in September 2007. A year earlier the difference was just 2%. For PPIs, differences between Medicare and commercial plans were not as striking as Statins, but nonetheless, Medicare plans demonstrated an 11% access advantage (53% compared to 42% of covered lives) in September 2007 and only a 5% difference a year earlier.
3. Parity: For the ARBs and Osteoporosis drug classes, there were minimal differences between the average tier 1 and tier 2 availability on commercial versus Medicare plans throughout the period analyzed.

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Archives

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