PCMA Statement on The Pharmacy Access Improvement (PhAIm) Act
August 2, 2007
(Washington, DC)— The Pharmaceutical Care Management Association (PCMA) issued the following statement today on The Pharmacy Access Improvement (PhAIm) Act of 2007, sponsored by Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Charles Grassley (R-Iowa):
“Medicare prescription drug plans and the pharmacy benefit managers (PBMs) who administer them are generating deeper-than-expected discounts and increasing access on prescription medicines for millions of America’s seniors.
“PBMs have accomplished this, in part, by employing state-of the-art, streamlined processes to both administer claims and offer the affordable mail-service pharmacy option. PCMA member companies currently pay pharmacies within 30 days by using scale efficiencies to ensure accuracy and timeliness. PBMs promote mail service pharmacy as an option that saves 10 percent on the cost of prescriptions and lowers costs for beneficiaries by spurring fair and healthy competition among drug retailers.
“In light of this, PCMA is particularly concerned with the “prompt pay,” extended dispensing, and any willing pharmacy provisions of the PhAIm Act. Reducing the payment cycle to 14 days for pharmacists in Medicare is less than half the 30-day standard used across the health care sector, including physician and hospital claims in Medicare Parts A&B, the federal employees’ health benefits plan (FEHBP) and 43 states. It would thrust new costs and administrative burdens upon Part D sponsors without offering any corresponding upside for beneficiaries.
“Provisions in the bill threaten to limit PDPs’ ability to encourage the appropriate use of the mail-service pharmacy option as a means to save money for beneficiaries and the program itself. An analysis by the Lewin Group projects that the use of mail-service pharmacy will save Medicare $48 billion over the next decade.
“Lastly, the any willing pharmacy provision would hinder the ability of Part D sponsors to generate competition among retailers. This could lead to increased costs while offering little, if any, value to beneficiaries. It is difficult to see how this provision would improve access for beneficiaries. According to SK&A Information Services, an average of 21 pharmacies are located and compete near independent pharmacies throughout the United States.”
Charles Coté 202-207-3605