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As major payers for prescription drugs (through Medicare Part D and Medicaid), the U.S.
Policymakers should encourage competition that enables purchasers to obtain price discounts from pharmaceutical manufacturers.
Well-designed drug formularies and PDLs should be used to enhance quality and conserve resources.
An exceptions and appeals process for coverage decisions must be in place. It should be clinically sound and well-communicated.
The Federal Trade Commission should monitor relationships between pharmacy benefit managers (PBMs) and vertically integrated acquisitions for effects on consumer choice, cl
Evidence-based clinical decision support systems should be broadly integrated.
States should prohibit insurers, health plans, and state Medicaid agencies from requiring enrollees to purchase prescription drugs only by mail.