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♦ Implemented for the first time in January 2006, the US Medicare prescription drug benefit program, Part D, is widely predicted to have a dramatic impact on the landscape of the Rx market. For pharmaceutical companies and manufacturers, the transformation in the business model is likely to reflect the new role of the regional stand-alone private drug insurance plans that are central to the program. Fundamental changes are also forecast in the Pharmacy Benefit Manager sector.♦ The US Centers for Medicare & Medicaid Services has projected that total payments to Medicare Rx plans will be more than $100 billion in 2009, and may reach $180 billion by 2015. In total, payments to the drug plans could total $1.2 trillion over the first 10 years of operation of Part D.