An analysis in the new issue of Health Affairs, by Jennifer Bowman and colleagues at Avalere Health, reveals that virtually all of the 3,000 Medicare Part D plans cover most cancer drugs, generally with low copayments. But some cancer drugs -- particularly brand names -- require prior authorization from a physician before the pharmacist can fill the prescription, potentially limiting access. http://content.healthaffairs.org/cgi/content/abstract/25/5/1240.

Massachusetts' plan to move toward universal coverage represents an impressive political achievement, and the plan's policy innovations offer important lessons to other states. However, the true significance of the Massachusetts experiment will become clear only after the state addresses daunting implementation challenges over the next several years. That's the verdict delivered by the two lead papers of a six-paper package on the Massachusetts experience published September 14 on the Health Affairs Web site. John McDonough, executive director of the Boston-based Health Care For All, teams with three colleagues from that organization to provide a comprehensive look at the important events and key players involved in the plan's package. John Holahan and Linda Blumberg (Urban Institute) survey the issues Massachusetts will have to address as it seeks to turn its path-breaking plan into reality. The six papers on Masschusetts' reform are available free on Health Affairs' Web site until September 28.

As the use of biopharmaceuticals spreads beyond rare diseases and academic subspecialists to more common conditions and community practices, health plans are attempting to manage these drugs through strategies such as medical management (formulary placement and prior authorization), network design (physician contracting arrangements and distribution of biopharmaceuticals through specialty pharmaceutical firms), and benefit design (coinsurance and annual payment limits). University of California, Berkeley, economist James Robinson says in the Sept./Oct. Health Affairs that these strategies have the potential to improve the manner in which biopharmaceuticals are prescribed, purchased, and used, but he cautions that health plans "cannot serve as society's fulcrum for comparing and balancing the cost and quality of novel therapeutics."