ARTICLE | Politics & Policy

UPC releases draft Medicare formulary guidelines

August 19, 2004 7:00 AM UTC

The U.S. Pharmacopeial Convention (UPC) released draft model guidelines for drugs covered under Medicare. The classification system includes 43 major categories, generally grouped by indication, which are followed by 138 pharmacologic drug classes, primarily based on mechanism of action. The framework of drug categories and classes are to be used by prescription drug sponsors, such as insurance companies, as they create their own formularies.

The Centers for Medicare & Medicaid Services (CMS) said the UPC draft model guidelines reflect a "starting point for structuring formulary categories and classes." The agency's formulary review standards and processes are under development, and a draft will be released in the fall for public comment. UPC was requested to prepare a model system under the Medicare Prescription Drug, Improvement and Modernization Act (MMA). The period for public comment on UPC's draft guidelines is open until Sept. 17. The draft guidelines can be found at ...