Drug coverage & spending: Council on Medical Service reports

These Council reports have proposed strategies to address high and escalating prescription drug prices and costs, including promoting transparency and pharmaceutical market competition, combating anti-competitive practices, and outlining criteria for value-based pricing and prescription drug importation.

2024

• Biosimilar Coverage Structures (PDF) CMS Report 4-I-24
• Economics of Prescription Medication Prior Authorization (PDF) CMS Report 6-A-24

• Prescription Drug Dispensing Policies (PDF) CMS Report 05-A-23

• Parameters of Medicare Drug Price Negotiation (PDF) CMS Report 04-A-22

• Access to Health Plan Information regarding Lower-Cost Prescription Options (PDF) CMS Report 2-N-21
• Continuity of Care for Patients Discharged (PDF) CMS Report 02-JUN-21

• Medicare Prescription Drug and Vaccine Coverage and Payment (PDF) CMS Report 3-November 2020
• Value-Based Management of Drug Formularies (PDF) CMS Report 6-November 2020

• Additional Mechanisms to Address High and Escalating Pharmaceutical Prices (PDF) CMS report 4-I-19
• The Impact of Pharmacy Benefit Managers on Patients and Physicians (PDF) CMS report 5-A-19
• Group Purchasing Organizations and Pharmacy Benefit Manager Safe Harbor (PDF) CMS report 8-A-19

• Canadian Pharmacies (PDF) CMS report 1-I-18
• Insulin Affordability (PDF) CMS report 7-A-18

• Access to Self-administered Medications (PDF) CMS report 4-A-16
• Medication "Brown Bagging" (PDF) CMS report 10-A-16
• Incorporating Value Into Pharmaceutical Pricing (PDF) CMS report 5-I-16

• Coverage for Chronic Pain Management (PDF) CMS-CSAPH joint report A-15
• Pharmaceutical Costs (PDF) CMS report 2-I-15. Read the issue briefs for this report: Improving drug price and cost transparency (PDF) and Prescription drug pricing and costs (PDF).
• Emergency Prescription Drug Refills (PDF) CMS report 3-I-15
• Parity of Payment for Administering Biologic Medications (PDF) CMS report 4-I-15

• Availability of Veterans Affairs Pharmacy Benefit (PDF) CMS report 2-A-10

• Radiology Benefits Managers (PDF) CMS report 5-I-09

• Payment for Biologic and Pharmacologic Agents (PDF) CMS report 3-I-08
• Comparative Effectiveness Research (PDF) CMS report 5-I-08

• Maximum Allowable Cost of Prescription Medications (PDF) CMS report 2-A-07
• Cost-sharing Arrangements for Prescription Drugs (PDF) CMS report 1-I-07

Access all council reports prior to 2007 or learn more about the Council on Medical Service.