Washington, DC; 05.26.04 — Mark Merritt, President & Chief Executive Officer of the Pharmaceutical Care Management Association (PCMA) released the following statement regarding the new Medicare drug discount card program:

” With all the attention being paid to Medicare drug discount cards and the cost of prescription drugs, one stubborn fact remains apparent: with discounts expected to average 17 percent for brand-name drugs and 35 percent for generics, America’s PBMs are helping to deliver real savings to seniors.

“Because of Medicare prescription drug discount cards, seniors and disabled Medicare beneficiaries will be paying less over the next 18 months for their prescription drugs. PBMs have helped drive down the cost of prescription drugs for over 200 million Americans in other parts of the system and we’re proud to be doing our part for seniors through the Medicare drug discount card program.

“Given that not one prescription has yet to be dispensed to seniors under this program, perhaps opponents should hit pause, take a deep breath, and think about what this program really means for beneficiaries, particularly the assistance provided to low-income seniors.

“Nor should we forget why this new program has been sorely needed. We already know what a world without PBMs working to lower drug prices for consumers looks like. Just ask any senior or uninsured American without drug coverage. They pay the highest drug prices of all at the retail pharmacy counter â?? or go without prescription drugs altogether.

“The politically-motivated attacks on the Medicare drug discount card program underscore just how valuable this program will prove to be to seniors over the long term â?? and how frightening that is to some politicians and their allies.”

# # #

The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmaceutical benefit managers (PBMs). PCMA member companies provide pharmaceutical care management services to more than 200 million Americans.

Contact Information:
Phil Blando
202-207-3614

Merritt: ‘Policymakers Should Take Heed: Efforts to Undermine PBMs’ Ability to Delivery Quality, Affordable Prescription Drug Benefit Will Only Harm Consumers’

Washington, DC; 05.18.04 — A new research analysis modeling increased prescription drug copayments and their effect on consumers’ use of prescription drugs suggests that employers are striking the right balance of quality and affordability in benefit plan design, and, the authors suggest, without PBMs’ proven tools, prescription drug costs in employer-sponsored health coverage would be far higher, the Pharmaceutical Care Management Association (PCMA) said today. PCMA is the national association representing pharmaceutical benefit managers (PBMs).

“This report suggests that, at a time of rising health care costs, employers have struck the right balance and are targeting scarce health care dollars effectively,” said PCMA President Mark Merritt. “Other peer-reviewed data have shown that increased copayments associated with multi-tier pharmacy benefits do result in reduced prescription drug spending, but do not result in higher use of other health care services. By working collaboratively, employers, physicians, pharmacists, health plans, and PBMs are assuring consumers access to a predictable, high-quality, and affordable prescription drug benefit.”

Modeling simulations were performed by researchers at the RAND Corporation, Merck & Co., and the California Healthcare Foundation and are published in the current issue of the Journal of American Medical Association (JAMA). The analysis examined the pharmacy claims data and health plan benefit designs from insured, working-age individuals from 30 employers and 52 health plans from 1997 to 2000. Notably, the models published in JAMA did not examine consumers’ actual prescription drug use and health outcomes associated with changes in copayments.

In many respects, the findings resulting from this modeling appear to echo similar findings by other researchers. In a first-of-its-kind 2001 study, a peer-reviewed analysis appearing in Medical Care,[1] the official journal of the Medical Care Section of the Journal of the American Public Health Association, found that higher copayments associated with a multi-tier pharmacy benefit helped reduce third-party payers’ prescription drug costs and, equally important, did not result in adverse consequences, such as higher emergency room use, inpatient hospital visits or physician office visits. The analysis examined medical and prescription claims data for more than 20,000 enrollees enrolled in preferred provider organizations (PPOs) from 1997-1999.

Among the key points from the new report in today’s issue of JAMA:

The very tools PBMs rely upon â?? including physician-directed generic substitution, mail-service pharmacy, and formulary development â?? have, as the authors note in the first paragraph, “large effects on drug spending” and serve to drive down drug spending. For example, the data confirm that a 90-day supply of prescription drugs dispensed through a mail-service pharmacy is much more cost-effective than that provided at the retail pharmacy.
Most individuals managing complex, chronic conditions — particularly those with hypertension and depression â?? continue to take the prescription drugs they need, regardless of increased copayments and particularly if there is no close substitute available over-the-counter. The exception to this trend appeared to relate to individuals managing diabetes. The reasons for this exception are not identified in the analysis. While not identified by this analysis, employers, PBMs, and others are pioneering innovative disease management programs to help address quality and cost issues associated with individuals managing chronic conditions.
Consumers are most price sensitive for prescriptions addressing symptoms or conditions with close over-the-counter substitutes, such as analgesics and antihistamines. These consumers are most likely to reduce utilization of prescription drugs seeing increased copayments.
PBMs increasingly are recognized as playing a critical role in assuring a high-quality, affordable, and integrated prescription drug benefit for consumers. According to the Centers for Medicare & Medicaid Services, the share of consumers’ out-of-pocket expenditures as a percent of total expenditures on prescription drugs declined by 30 percent between 1995 and 2002 â?? a time when PBM market penetration grew significantly. Moreover, other data suggest that, in 2002, consumers’ prescription drug copayments for most “tier 1″ prescriptions remained under $10 dollars.[2]

PCMA believes these data also should serve as an important guide to those policymakers seeking to undermine PBMs’ cost-savings tools and quality improvement initiatives. Without PBMs in the system, prescription drug costs would be far higher, medical errors more prevalent, and consumers would be more likely to forgo needed medicines that would help hold down overall health care costs.

“Policymakers should take heed: efforts to undermine PBMs’ tools and techniques will only harm consumers,” Mr. Merritt added. “Without PBMs in the system, prescription drug costs for consumers would be substantially higher.”

# # #

The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmaceutical benefit managers (PBMs). PCMA member companies provide pharmaceutical care management services to more than 200 million Americans.

Contact Information:
Phil Blando
202-207-3614

‘Why?’

PCMA Calls on Independent Community Pharmacy Group Also to Explain Characterization Of Medicare Drug Discount Card Program as ‘73 Routes to Chaos’

Washington, DC; 05.17.04 — The Pharmaceutical Care Management Association (PCMA) has launched a new advertising initiative challenging an independent community pharmacy trade group to explain “Why?” they are working to undermine Medicare beneficiaries’ access to safer and more affordable prescription drugs through new Medicare prescription drug discount cards, the association announced today. PCMA is the national association representing America’s pharmaceutical benefit managers (PBMs).

“At a time when others in the pharmacy community are working together to make the new Medicare drug discount card program a success for seniors, the independent community pharmacy lobby is trying feverishly to preserve their ability to charge seniors the highest drug prices of all,” said PCMA President & CEO Mark Merritt. “They owe America’s seniors an explanation as to ‘why?’”

As part of PCMA’s new advertisement, the association is challenging the independent community pharmacy group to explain the following to America’s seniors:

Why are they supporting sponsors of legislation to undo the new Medicare drug law?
Why are they actually bragging that they “have fought discount cards since day one?”
Why did they sue the Bush administration â?? twice â?? to prevent seniors from getting Medicare drug cards â?? cards that provide seniors average discounts of 25 percent or more?
And why are they trying to keep seniors from enjoying the safety, cost savings, and convenience of mail-service pharmacies?
In a related matter, PCMA today also called upon a representative of the independent community pharmacy lobby to explain a comment he provided to this past Saturday’s Akron Beacon Journal (Ohio) in which he called the 73 drug discount cards approved by Medicare as “73 routes to chaos.”

“America’s seniors deserve clear, unbiased information about the choices available to them to help lower the cost of prescription drugs,” added Mr. Merritt. “Regrettably, the comment provided this weekend by a representative of the independent community pharmacy lobby serves only to help those who don’t want the Medicare drug discount card program to succeed.”

# # #

The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmaceutical benefit managers (PBMs). PCMA member companies provide pharmaceutical care management services to more than 200 million Americans.

Contact Information:
Phil Blando
202-207-3614

Merritt: ‘Data are Fresh Reminder of the Power of Choice, Information & Competition In Lowering Drug Prices for Seniors’

Washington, DC; 05.14.04 — Mark Merritt, President & Chief Executive Officer of the Pharmaceutical Care Management Association (PCMA), issued the following statement regarding new data released today by the Centers for Medicare & Medicaid Services showing that the cost of prescription drugs available through Medicare-sponsored drug discount cards has fallen by more than 10 percent for both brand-name and generic prescription drugs in the past week alone:

“New data released today by the Medicare program confirm that Medicare drug discount cards are working as intended and driving down the cost of both brand-name and generic drugs for seniors â?? on average by an additional 10 percent in the past week alone.

“America’s PBMs have been proven to lower the cost of prescription drugs for consumers in other parts of the health care system and, as these data suggest, are now doing their part in Medicare.

“With PBMs slated to administer a majority of Medicare-sponsored drug discount cards, these data are a fresh reminder of the power of choice, information, and competition and the benefit they provide to consumers.”

# # #

The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmaceutical benefit managers (PBMs). PCMA member companies provide pharmaceutical care management services to more than 200 million Americans.

Contact Information:
Phil Blando
202-207-3614

CIGNA Pharmacy Management President James H. Bryant Elected To PCMA Board of Directors

Washington, DC; 05.11.04 — James H. Bryant, President of CIGNA Pharmacy Management, has been elected to the Board of Directors of the Pharmaceutical Care Management Association (PCMA), the association announced today.

“We are proud to announce that Jim Bryant of CIGNA Pharmacy Management has been elected to the PCMA Board of Directors,” said PCMA President Mark Merritt. “Jim’s expertise, energy, and diverse background will play a central role in helping the industry to articulate the value PBMs bring to the system and the role they play in keeping prescription drugs safe, effective, and affordable for consumers.”

“CIGNA Pharmacy Management is pleased to have the opportunity to work closely with PCMA to help elected officials, opinion leaders, and the general public better understand our industry and the contribution we make in keeping the American system one of the finest health care systems in the world,” said Mr. Bryant.

CIGNA Pharmacy Management is a pharmacy benefits manager offering a full range of services including clinical management programs, access to retail and home delivery pharmacy services, health improvement programs and specialty pharmacy services. Serving more than 8 million consumers, CPM helps to improve the health of its members while working with employers to control rising drug costs. Through its clinical expertise and broader health care knowledge, CPM also provides account management and consultative services to clients to help them achieve optimal results from their pharmacy benefit.

Mr. Merritt added, “CIGNA Pharmacy Management’s participation will only enhance PCMA’s ability to speak with one voice for the broad spectrum of stand-alone PBMs and health plans’ subsidiary PBMs.”

“CIGNA Pharmacy Management” refers to various operating subsidiaries of CIGNA Corporation (NYSE:CI). Products and services are provided by these subsidiaries and not by CIGNA Corporation. These subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., and HMO or service company subsidiaries of CIGNA Health Corporation.

PCMA is the national association representing pharmaceutical benefit managers (PBMs). Together, PCMA member companies provide services to more than 200 million Americans provided coverage through small and large employers, health plans, union-sponsored plans, and state and federal government health care programs.

# # #

The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmaceutical benefit managers (PBMs). PCMA member companies provide pharmaceutical care management services to more than 200 million Americans.

Contact Information:
Phil Blando
202-207-3614

Merritt: Data Confirms Recent PCMA Survey Showing Seniors To See Meaningful Discounts through Drug Card Program

Washington, DC; 05.06.04 — New government data suggests that seniors and disabled Medicare beneficiaries will save hundreds of dollars per year on the cost of their prescription drugs with new Medicare-sponsored prescription drug discount cards, the Pharmaceutical Care Management Association said today. PCMA is the national association representing pharmaceutical benefit managers (PBMs).

“These new government data should be a reality check for critics and demonstrate that Medicare drug discount cards will provide seniors with meaningful help on the cost of their prescription drugs,” said PCMA President Mark Merritt. “PBMs save consumers money in the private sector and we are proud to bring those same benefits to Medicare beneficiaries.”

A majority of Medicare-approved drug discount cards will be sponsored and/or administered by PBMs. These data confirm a recent PCMA survey of PBMs finding that seniors enrolling in a Medicare-sponsored PBM drug card would see average savings of 17 percent for brand-name drugs and 35 percent for generics.

The Centers for Medicare & Medicaid Services (CMS) conducted the analysis and notes that “our results mean Medicare beneficiaries without prescription drug coverage will no longer have to pay the highest retail prices for their prescription drugs.” CMS notes that Medicare beneficiaries enrolling in Medicare-approved drug discount card programs should expect deeper discounts than what many consumers with third-party drug coverage enjoy. The CMS analysis specifically notes the following:

For brand-name drugs, card sponsors are negotiating discounts for beneficiaries in the range of 10-17 percent below the average retail pharmacy price paid by consumers (including non-seniors with third-party drug coverage);
For generic drugs, card sponsors are negotiating discounts for beneficiaries in the range of 30-60 percent below the average price paid by consumers;
Mail-service pharmacies are providing 10-13 percent discounts below those offered by Internet pharmacies;
Medicare-approved drug discount cards offer a lower enrollment fee â?? in some cases, no fee at all â?? than Internet pharmacies; and
In just one month, beneficiaries will see savings that exceed the maximum allowable $30 dollar annual enrollment fee, although many card sponsors are charging far less or no enrollment fee.

# # #

The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmaceutical benefit managers (PBMs). PCMA member companies provide pharmaceutical care management services to more than 200 million Americans.

Contact Information:
Phil Blando
202-207-3614

Merritt: Data Confirms Recent PCMA Survey Showing Seniors To See Meaningful Discounts through Drug Card Program

Washington, DC; 05.06.04 — New government data suggests that seniors and disabled Medicare beneficiaries will save hundreds of dollars per year on the cost of their prescription drugs with new Medicare-sponsored prescription drug discount cards, the Pharmaceutical Care Management Association said today. PCMA is the national association representing pharmaceutical benefit managers (PBMs).

“These new government data should be a reality check for critics and demonstrate that Medicare drug discount cards will provide seniors with meaningful help on the cost of their prescription drugs,” said PCMA President Mark Merritt. “PBMs save consumers money in the private sector and we are proud to bring those same benefits to Medicare beneficiaries.”

A majority of Medicare-approved drug discount cards will be sponsored and/or administered by PBMs. These data confirm a recent PCMA survey of PBMs finding that seniors enrolling in a Medicare-sponsored PBM drug card would see average savings of 17 percent for brand-name drugs and 35 percent for generics.

The Centers for Medicare & Medicaid Services (CMS) conducted the analysis and notes that “our results mean Medicare beneficiaries without prescription drug coverage will no longer have to pay the highest retail prices for their prescription drugs.” CMS notes that Medicare beneficiaries enrolling in Medicare-approved drug discount card programs should expect deeper discounts than what many consumers with third-party drug coverage enjoy. The CMS analysis specifically notes the following:

For brand-name drugs, card sponsors are negotiating discounts for beneficiaries in the range of 10-17 percent below the average retail pharmacy price paid by consumers (including non-seniors with third-party drug coverage);
For generic drugs, card sponsors are negotiating discounts for beneficiaries in the range of 30-60 percent below the average price paid by consumers;
Mail-service pharmacies are providing 10-13 percent discounts below those offered by Internet pharmacies;
Medicare-approved drug discount cards offer a lower enrollment fee â?? in some cases, no fee at all â?? than Internet pharmacies; and
In just one month, beneficiaries will see savings that exceed the maximum allowable $30 dollar annual enrollment fee, although many card sponsors are charging far less or no enrollment fee.

# # #

The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmaceutical benefit managers (PBMs). PCMA member companies provide pharmaceutical care management services to more than 200 million Americans.

Contact Information:
Phil Blando
202-207-3614

Compromising Quality: The High Cost of Government Drug Purchasing

Compromising Quality: The High Cost of Government Drug Purchasing

Compromising Quality: The High Cost of Government Drug Purchasing