PCMA: PBMs Negotiating Lower Drug
February 21, 2007
(Washington, DC)—New government data estimating that Medicare prescription drug plans sharply reduced the rate of growth in prescription-drug prices in 2006 affirms the central role of pharmacy management tools in Part D and serves as a timely reminder to policymakers that Part D is working as Congress intended, the Pharmaceutical Care Management Association (PCMA) said today.
“These new data underscore why seniors and the disabled have consistently reported high satisfaction with the savings and choices available through Medicare Part D,” said PCMA President Mark Merritt. “Beneficiaries have wide access to hundreds of brand-name and lower-cost generic drugs at thousands of retail and mail-service pharmacies throughout America â?? and all at lower-than-expected costs. This track record shows Medicare Part D is working as Congress intended and that policymakers should think long and hard before making wholesale changes to the program.”
PCMA believes strongly that the new data make the case for increased reliance of pharmacy management tools in Medicare Part D. With Medicare taking on an increasing share of the prescription-drug dollar, it is critical that policymakers build on proven management tools. In the private marketplace, PBMs have used their expertise on behalf of Fortune 500 employers, labor unions, and health insurers to drive down the rate of growth in prescription-drug trend by 68 percent since 1999. In 2005, the rate of growth in prescription-drug trend was at the lowest level in over a decade. PBMs rely on a wide range of tools â?? including formularies and increased use of generics and mail-service pharmacies â?? to help preserve broad access while driving down costs.
These new data also concur with a recent PCMA-commissioned report by PricewaterhouseCoopers (PwC) finding that Medicare drug plans will save Medicare and its beneficiaries $469 billion between 2006-2015, if current program performance is maintained. PwC estimates that Part D plans are negotiating drug discounts averaging 29 percent. PwC also found that for each percentage point increase in overall generic utilization, Part D drug spending falls by an estimated $12 billion over the 2007 to 2015 period. Medicare recently reported that the generic drug-dispensing rate in Part D totaled about 60 percent â?? exceeding the dispensing rate in the commercial marketplace.
PCMA is the national association representing America’s pharmacy benefit managers (PBMs), which lower the cost of prescription drugs for more than 200 million Americans with coverage provided through Fortune 500 employers, health insurers, labor unions, and Medicare Part D
Phil Blando, 202-207-3614
Charles Coté 202-207-3605