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The Medicare Prescription Drug, Improvement, and Modernization Act, [1] also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. [2] It produced the largest overhaul of Medicare in the public health program's 38-year history.
A formulary is a list of pharmaceutical drugs, often decided upon by a group of people, for various reasons such as insurance coverage or use at a medical facility. [1] Traditionally, a formulary contained a collection of formulas for the compounding and testing of medication (a resource closer to what would be referred to as a pharmacopoeia ...
As of 2023, PBMs managed pharmacy benefits for 275 million Americans and the three largest PBMs in the US, CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx, make up about 80% of the market share covering about 270 million people [4] [5] with a market of almost $600 billion in 2024.
About 5.3 million people on Medicare used the drugs between Nov. 1, 2023, and Oct. 1, 2024, according to the CMS. Together, the 15 drugs selected accounted for $41 billion, or 14%, of total ...
Medicare Advantage in 2024: Enrollment Update and Key Trends, KFF. Accessed September 6, 2024. Medicare Advantage and Medicare Prescription Drug Programs to Remain Stable in 2024, U.S. Centers for ...
Original Medicare. 2024 cost. Part A. $0 in most cases, thanks to Medicare taxes from working 10 years or more. ... Medicare & You 2025 [PDF], Medicare.gov. Accessed October 15, 2024.
By 2011 in the United States a growing number of Medicare Part D health insurance plans—which normally include generic, preferred, and non-preferred tiers with an accompanying rate of cost-sharing or co-payment—had added an "additional tier for high-cost drugs which is referred to as a specialty tier".
The standard Part B monthly premium rose from $174.70 in 2024 to $185.00 in 2025. Original Medicare's premiums and deductibles went up in 2025. The Part A annual deductible increased from $1,632 ...