来　源：	慧典市场研究报告网 http://www.hdcmr.com/
名　称：	Medicare Part D - Its impact on US drug pricing issues and role as a driver towards European style pricing mechanisms
关键词：

CHAPTER 1 EXECUTIVE SUMMARY 
Scope of the report 
Key findings 


CHAPTER 2 WHAT IS MEDICARE PART D? 
Key Findings 
Overview 
Volume Gains Versus Price Discounts 
Demographic Trends Drive Reform Efforts 
Negative Sentiment Towards Drug Prices on the Increase 
Fuelled by European Trends 
How it works 
Who Will Enroll 


CHAPTER 3 BROAD ACCESS TO DRUGS - A FORMULAR(Y) FOR SUCCESS? 
Key Findings 
Introduction 
The US pharmaceutical market 
Medicare Part D Formularies 
Expansive Formularies Get Nod over Cost Control 
Tiered Co-Payments - Effective in Theory But Not in Practice 
Non-Discrimination Policy Dominates Proceedings 
Outlook 


CHAPTER 4 HOW MUCH WILL IT REALLY COST? CAN THE GOVERNMENT AVOID BUDGETARY OVERRUN? 
Key Findings 
Introduction 
US Health Expenditure Trends 
Medicare Part D drives Cost Shift 
Government Cost Projections 
The Non-Interference Clause 
Outlook 
CHAPTER 5 WHY MANAGED CARE WILL DICTATE MEDICARE PART D 
Key Findings 
Introduction 
Private Insurance Sector 
Tiered Co-Payments 
Case Study: Implications of generic simvistatin 
Tiered Co-Payments in Medicare Part D 
Beneficiary Migration Patterns 


CHAPTER 6 THE INFLUENCE OF EUROPEAN PRICING MEASURES ON FUTURE US POLICY 
Key Findings 
Introduction 
European Price Controls 
Impact on US Pricing Strategies 
German Drug Pricing 
Overview 
Background 
Reference Pricing 
Lipitor Hit Again 


CHAPTER 7 - CONCLUSIONS 
Medicare Part D - Short Term Fix for Pharma Woes 
Generics market to remain a thorn in the side of Big Pharma 
Aggressive co-payments to proliferate in Medicare and managed care plans 
Me-too drugs to face greatest price cuts 
Innovative drugs to command higher prices 
Pfizer finds itself a high profile casualty 
Is the industry fighting a wider war by 'proxy'? 


List of Tables 
Table 1: Components of US Market Growth 1999-2003 
Table 2: Examples of Reference Pricing Impact in Statin and PPI Classes 


List of Figures 
Figure 1: Overview of US Health Insurance Sector 
Figure 2: Standard Medicare Part D Benefit Design for an Individual in 2006 
Figure 3: Distribution of Medicare Beneficiaries and Prescription Drug Expenditure, 2005 
Figure 4: Projected Medicare Enrollee Participation in Part D 
Figure 5: US and European Retail Drug Market Growth Rates (CER) 
Figure 6: Final Part D Formulary Guidelines: Increased Granularity in the Anti-ulcer Drug Class Benefits Manufacturers 
Figure 7: The impact of the "All or Substantially All" drug provision on the anti-depressant class category 
Figure 8: International Health Expenditure Comparison 
Figure 9: Impact of Medicare Part D on Federal Drug Expenditure 
Figure 10: Projected Net Federal Cost of Medicare Part D 
Figure 11: Breakdown of Employer-Sponsored Insurance Schemes, 2004. 
Figure 12: Annual Growth Rate for Employer-Sponsored Insurance Premiums, 1999-2004. 
Figure 13: Typical Tiered Co-Payment System, reflecting less coverage for more expensive pharmaceuticals 
Figure 14: Statin Step Therapy Regime as used by California-based Kaiser Permanente 
Figure 15: Overview of Pricing and Reimbursement Policy in France, UK, Italy and Spain. 
Figure 16: Branded Pharmaceutical Sales at Risk by Year 
Figure 17: Examples of Drug Classes with Exaggerated 'Me Too' Characteristics

The imminent introduction of Medicare Part D will take place with the US drug market in a transitional period. Negative sentiment towards high prices in the US market has gained currency in recent years, while growth in generics continues to outstrip branded drug sales. Concurrently, the industry is facing tougher pricing measures in the EU and cannot afford for these to be replicated in the US.

Scope

Evaluation of Medicare Part D, including beneficiary enrolment analysis and an overview of the formulary models that will be utilized by providers
Examination of projected expenditure trends for Part D and the medium to long term repercussions of political re-direction
Assessment of the impact on current pharmaceutical pricing trends in the US private sector, and an analysis of the relationship with Medicare Part D
An analysis of pricing trends in key European markets, including an in-depth focus on the German reference pricing system
Highlights
Although Medicare Part D will provide expansive prescription drug coverage to a wider selection of senior beneficiaries, its positive impact on the drug industry will be short lived. Within a few years, the Bush administration will face unsustainable pressure to reduce funding for the scheme and implement more restrictive cost saving measures.

With the private health insurance sector already demonstrating a more cost conscious approach, the use of mechanisms such as tiered co-payments will gain further credence, fuelled by a raft of blockbuster drugs coming off patent.

The European drug market remains a more difficult pricing and reimbursement environment for drug manufacturers. Concern remains that such measures could be repeated in the US, hence heavy industry lobbying.

Reasons to Purchase
Understand how Medicare Part D will be implemented and its impact on the drug industry
Assess the implications on pricing measures used in the managed care sector
Understand the potential convergence between US and European drug pricing trends