Washington, DC; 01.27.05 — Mark Merritt, President of the Pharmaceutical Care Management Association (PCMA), issued the following statement in response to the US Department of Health & Human Services issuing the proposed rule governing electronic prescribing (e-prescribing) in the new Medicare prescription drug benefit. PCMA is the national association representing America’s pharmacy benefit managers:

“The proposed Medicare e-prescribing rule is an historic step that, over the long term, will help save lives, improve quality, and reduce unnecessary costs for millions of Americans. Medicare e-prescribing is the catalyst that will spark a health-information technology revolution throughout the entire health care system.

“America’s pharmacy benefit managers look forward to working closely with the Administration, Members of Congress from both sides of the aisle, consumers, physicians, pharmacists, employers, and others to make the promise of e-prescribing a reality. In the commercial marketplace, PBMs have pioneered the most sophisticated e-prescribing infrastructure and other health-information management tools to help employers, health insurers, and others to improve outcomes, promote safety, and reduce costs.

“In the coming months, PCMA will be reviewing the proposed rule in detail and providing comments to the Centers for Medicare & Medicaid Services.”

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The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmacy 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: ‘CVS Seeking to Undermine Employers’ Ability to Rely upon Mail-Service Pharmacies For Controlling Rx Drug Costs’

Analysis Finds Mail-Service Pharmacies to Save $100 Billion on Prescription Drug Costs over Next Decade

(Washington, DC)—Today’s announcement by CVS Corporation (NYSE: CVS) that it is dumping more than 140,000 consumers from its pharmacy networks simply because consumers and employers want access to more cost-effective prescriptions available at mail-service pharmacies is a short-sighted attack that will ultimately backfire, the Pharmaceutical Care Management Association (PCMA) said today. PCMA is the national association representing America’s pharmacy benefit managers (PBMs).

“With today’s announcements, CVS is seeking to undermine an important option employers rely upon in addressing prescription drug costs and improving access: the mail-service pharmacy option,” said PCMA President Mark Merritt. “At a time when employers are struggling to stretch scarce health care dollars, CVS has effectively told them that they should be paying higher prices for prescription drugs. CVS’ short-sighted effort to protect their ability to charge higher drug prices will ultimately backfire.”

The mail-service pharmacy option is an important avenue for consumers and employers seeking more cost-effective options for purchasing prescription drugs. Numerous data indicate that even deeper discounts are available through mail-service pharmacies than through the savings PBMs are able to negotiate with retail pharmacies. Consumers and employers will save nearly $100 billion on prescription drug costs over the next decade because of PBM mail-service pharmacies, according to PricewaterhouseCoopers. PBM mail-service consumers report high satisfaction on a wide range of measures, including condition of drugs received, ease of refilling prescriptions, and timeliness of drug delivery.

According to a recent Hewitt Associates survey of large employers, America’s businesses are relying on the very tools and techniques pioneered by PBMs to help manage their pharmacy benefits: multi-tier formularies, mail-order pharmacies, generic substitution, step therapy and many other common-sense approaches.

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

Contact Information:
Phil Blando
202-207-3614

Harvard Analysis of 670 Million Prescription Drug Claims Finds Generic Dispensing & Substitution Rates Essentially Same at Retail & Mail-Order Pharmacies

Washington, DC; 01.13.05 — Comments made yesterday by Walgreens’ senior leadership about generic-drug dispensing and substitution rates at mail-order pharmacies and published in today’s Chicago Tribune are flat-out wrong, the Pharmaceutical Care Management Association (PCMA) said today. PCMA is the national association representing America’s pharmacy benefit managers (PBMs).

“Walgreens is flat-out wrong,” said PCMA President Mark Merritt. “According to a peer-reviewed analysis of 670 million prescription-drug claims by Harvard Business School, mail-service pharmacies dispense and substitute generic drugs at essentially the same rate as retail pharmacies. Moreover, mail-service pharmacies do so more cost-effectively than retail pharmacies and will save American consumers and employers $100 billion on prescription drug costs over the next decade.”

In July 2004, an independent peer-reviewed analysis of 670 million prescription drug claims by Harvard Business School economists concluded that generic drug-dispensing rates and generic substitution rates are essentially the same at retail and mail-order pharmacies. The analysis â?? which was independent and not funded by the PBM industry â?? was conducted by Marta Wosinska, Ph.D., and Robert Huckman, Ph.D., of the Harvard Business School and was posted on Health Affairs website on July 28, 2004.

The Harvard Business School analysis examined 670 million prescription drug claims processed by five large PBMs during the first six months of 2003. The analysis compared generic drug dispensing and substitution patterns at PBM-owned mail-service pharmacies versus retail pharmacies. In a fundamental difference from retail-pharmacy funded studies, this analysis adjusted for “therapeutic mix.” In plain English, the Harvard analysis takes into account the differences in the types of drugs consumers seek at mail-service pharmacies versus retail pharmacies. In the retail pharmacy setting, consumers typically seek prescriptions for acute conditions, whereas mail-service pharmacies are more likely to dispense prescriptions treating chronic conditions. The authors assert that this “therapeutic mix” adjustment is essential to allowing direct comparisons between PBM mail-service pharmacies and retail pharmacies.

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

Contact Information:
Phil Blando
202-207-3614

Health Spending Growth Slows in 2003

Washington, DC; 01.11.05 — Mark Merritt, President of the Pharmaceutical Care Management Association (PCMA), released the following statement on new data out today on US prescription drug spending in 2003. The data analysis was conducted by researchers at the Centers for Medicare & Medicaid Services (CMS) and posted on Health Affairs’ website. PCMA is the national association representing America’s pharmacy benefit managers (PBMs):

“These new government data out today provide welcome news that PBMs’ tools and techniques have helped reduce the rate of growth in prescription drug spending by nearly 40 percent from a peak in 1999. Multi-tier formularies and expanded access to cost-effective generics are among the chief causes cited by researchers for the marked decline in the rate of growth in US drug spending.

“These data also highlight other challenges. In Medicaid â?? which does not utilize the full menu of PBMs’ tools â?? prescription drug spending grew at more than twice the rate of private health-insurance drug spending. According to the analysis, this growth was due in part to states being limited in the tools they could use to curtail drug-spending growth. In addition, consumers and private and public purchasers are spending more than ever on prescriptions, but without the right kind of information that can help them compare the effectiveness and safety of competing drugs.

“These new government data underscore the challenges facing consumers, employers, physicians, pharmacists, PBMs, drug makers, and policymakers in the New Year. Now is the time to jumpstart a prescription-drug discussion centered on information, quality, and affordability. Otherwise, the progress achieved over the past four years could prove elusive and threaten to unravel the system over the long term.”

RELATED LINKS:
Health Spending Growth Slows in 2003

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

Contact Information:
Phil Blando
202-207-3614

Report Highlights Need for Greater Collaboration among Pharmacists, Physicians & Others to Promote Drug Safety & Quality

Washington, DC; 01.07.05 — A new independent analysis suggesting that fatal medication errors increase by 25 percent at the beginning of each month at retail pharmacies should serve as a wakeup call to policymakers that any examination of how best to promote drug safety and efficacy throughout the health care system should include reducing medication errors at pharmacies, the Pharmaceutical Care Management Association (PCMA) said today. PCMA is the national association representing America’s pharmacy benefit managers (PBMs).

Coming at a time of increased attention on drug safety, PCMA believes this analysis highlights the need for greater collaboration by consumers, pharmacists, physicians, purchasers, PBMs, and others to promote optimal drug use by patients and improve health care quality and safety.

The analysis, “A Spike in Fatal Medication Errors at the Beginning of Each Month,” is published in the January 2005 edition of Pharmacotherapy, the Journal of the American College of Clinical Pharmacy. The analysis was conducted by researchers affiliated with the University of California in La Jolla, Calif. and Tufts University School of Medicine in Boston, Mass.

Researchers examined more than 47 million death certificates from 1979 to 2000 and found “that some types of fatal medication errors spike by 25 percent above normal at the beginning of the month.” The increase in fatal medication errors did not vary by socioeconomic status and was not larger for substance abuse users than for others. The researchers found that more than 125,000 deaths occurred as a result of medication errors in the timeframe studied.

The researchers suggest a likely cause for the increase in errors is that “because there is an increased pharmacy workload at the beginning of each month, some pharmacists may be unusually prone to error in the filling and labeling of prescriptions and may have less time than usual to explain necessary precautions to their patients.”

To reduce potentially fatal medication errors at retail pharmacies and to save lives, the researchers offer several suggestions:

When filling prescriptions at the beginning of the month, patients should “be especially careful to check the accuracy” of their prescription and “intensified checking” should be practiced by clinical staff.
Pharmacies that do not already do so “might consider” increasing staff levels at the beginning of the month.
To the extent that distribution of government payments at the beginning of the month â?? Social Security and other assistance â?? causes a corresponding increase in traffic at retail pharmacies, government officials might consider spreading payments out over the entire month.
In addition to these suggestions, patients should also consider exploring other alternatives, particularly the mail-service pharmacy option provided by PBMs. Backed by a safety infrastructure, PBM mail-service pharmacies dispense 90-day supplies of brand-name and generic maintenance drugs to millions of patients. In March 2004, one national PBM released a safety analysis finding that automated technology relied upon at PBM mail-service pharmacies to dispense prescriptions was 23 times better than at retail. Patients using the mail-service pharmacy option report very high satisfaction on a wide range of measures, including condition of drugs received, ease of refilling prescriptions, and timeliness of drug delivery.

The PBM mail-service pharmacy option is also much more cost-effective for patients. According to an analysis by PricewaterhouseCoopers, without the mail-service pharmacy option, prescription drug spending would increase by nearly $100 billion dollars over the next ten years. Data from the Government Accountability Office and other independent sources have yielded similar findings about the cost savings provided to consumers and purchasers through PBM mail-service pharmacies.

RELATED LINKS:
A Copy of the Analysis

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

Contact Information:
Phil Blando
202-207-3614

Washington, DC; 01.03.05 —The Pharmaceutical Care Management Association (PCMA) released the following statement in response to final model Medicare formulary guidelines unveiled today by the US Pharmacopeia (USP). PCMA is the national association representing America’s pharmacy benefit managers (PBMs):

“America’s seniors and disabled Medicare beneficiaries deserve a prescription drug benefit that builds upon the proven record of pharmacy benefit managers in balancing cost, access, and quality for millions of Americans. Working collaboratively with consumers, pharmacists, physicians, employers, health insurers, and others, PBMs help drive down the cost of prescription drugs by an average of 25 percent, improve clinical outcomes, and help keep drug benefits affordable.

“US Pharmacopeia has completed a difficult task. While more expansive than what is typically found in the commercial marketplace, USP’s model Medicare formulary guidelines preserve the ability of PBMs to develop formularies that reflect those found in the commercial market. In addition, the Centers for Medicare and Medicaid Services (CMS) has also recently provided additional insight on how it will evaluate Medicare formularies, which further acknowledges the value of commercial-market practices.

“Taken together, PCMA believes the model formulary guidelines represent a workable approach that will assure Medicare beneficiaries access to the medicines they need.”

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

Contact Information:
Phil Blando
202-207-3614