Medicare Part D, Generics, & E-Prescribing Centerpiece
of Pro-Consumer Agenda

(Washington, DC)—As Congress and the Administration seek bipartisan, real-world solutions to improve quality and rein in health-care costs in public and private programs, the Pharmaceutical Care Management Association (PCMA) today announced an ambitious agenda for 2007 centered on preserving and enhancing the competitive model in Medicare Part D; expanding access to lower-cost generic drugs; and revolutionizing the prescription-drug delivery system with cutting-edge electronic-prescribing technology.

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.

“At a time when policymakers in Washington are looking for real-world solutions, PCMA has put forward a pro-consumer agenda to improve health care, but without requiring billions of dollars in new federal spending,” said PCMA President Mark Merritt in announcing the new initiative. “PBMs have a proven track record in the private market of driving down prescription drug costs, while ensuring broad access to needed medications through 55,000 retail pharmacies. We urge policymakers to build on this model in 2007. PCMA’s policy agenda is unique in that it would improve the health care system and save consumers, employers, and taxpayers tens of billions of dollars.”

In 2007, PCMA and its member companies will be working on a wide range of issues, including:

· Preserving the PBMs’ cost-saving model in Medicare Part D & the commercial market;

· Creating a legal pathway for biogenerics, or follow-on biologics;

· Adopting a national, uniform electronic (e)-prescribing standard;

· Removing barriers and expanding access to conventional generics;

· Promoting value-based purchasing through comparative effectiveness; and

· Opposing proposals â?? including one-size-fits-all disclosure and independent-pharmacy protection such as sweeping collective bargaining rights and prompt-pay mandates â?? that would result in increased costs for consumers and private and public payors with no corresponding benefit.

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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

Contact Information:
Phil Blando, 202-207-3614
Charles Coté 202-207-3605

(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.

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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

Contact Information:
Phil Blando, 202-207-3614
Charles Coté 202-207-3605

educing Drug Costs for Consumers and Employers

(Washington, DC)—Proclaiming it to be the “next step” toward increasing access and reducing prescription drug costs for consumers and employers, the Pharmaceutical Care Management Association (PCMA) today endorsed the “Access to Life Saving Medicine Act of 2007,” legislation that seeks to create a clear regulatory pathway for follow-on biologics, or “biogenerics.” 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.

Unlike conventional drug products where generic competition exists, the FDA currently lacks a clear regulatory pathway to approve follow-on biologics, or “biogenerics.” The “Access to Life Saving Medicine Act of 2007″ seeks to rectify this situation by creating a clear pathway that would enhance competition and in turn reduce costs and increase access for life-enhancing biologics.”

“PCMA applauds the leadership demonstrated by policymakers on this important health care issue,” said PCMA President Mark Merritt. “Biologics positively impact the lives of millions of Americans and this legislation is the next step toward introducing increased competition in the marketplace that will reduce costs, while increasing access and patient compliance.”

According to recent data contained in a report authored by researchers from the Centers for Medicare & Medicaid Services (CMS), competition from generic alternatives and other proven management tools utilized by PBMs helped slow prescription drug-spending in 2005 to its lowest growth rate in over a decade, rising just 5.8 percent. The 5.8 percent prescription-drug growth rate in 2005 represented a 33 percent reduction from the 2004 growth rate of 8.6 percent and a dramatic decline from 1999 when drug trend was running at 18.2 percent.

“With PBMs playing an integral role in the effort to expand consumers and payors’ options for savings in both the public and private sector, we strongly encourage both Democrats and Republicans to support this measure and vote for its passage,” said Merritt.

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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

Contact Information:
Phil Blando, 202-207-3614
Charles Coté 202-207-3605

PCMA-Commissioned Data Finds for Each Percentage Increase in Generic Drug Use, Medicare Part D Spending Falls by $12 Billion

(Washington, DC)—New data released today by the Centers for Medicare & Medicaid Services (CMS) showing generic-drug utilization exceeding 60 percent in Medicare Part D underscores the role of pharmacy benefit managers (PBMs) in expanding access to lower cost, clinically proven prescription drugs. 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.

“The high generic dispensing rate in Medicare Part D â?? after only one year â?? is a testament to the collaborative efforts of patients, clinicians, PBMs, and policymakers to expand access to clinically proven, cost-effective prescription drugs,” said PCMA President Mark Merritt. “Increased generic drug utilization is helping to keep Part D premiums and program costs lower than originally forecast and is helping to prevent seniors from falling into the ‘donut hole’ coverage gap.”

In recent months, numerous data have shown the important role that increased use of generic drugs can play in lowering health care costs. A recent analysis from PricewaterhouseCoopers examined the role of generic drugs in lowering Part D spending:

�· 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.

�· If Medicare prescription drug plans were able to increase generic dispensing rate by 5 percentage points, savings could increase by $58 billion over the 2007 to 2015 period.

In addition, a recent report authored by researchers from CMS found that competition from generic alternatives and other proven management tools utilized by PBMs helped contribute to prescription drug-spending growth rate in 2005 slowing to its lowest growth rate in over a decade, rising just 5.8 percent.

PCMA also believes these data serve as a timely reminder to policymakers about the need to expand access to generic drugs, including providing a clear regulatory pathway for follow-on “biogeneric” drugs and eliminating unnecessary hurdles which limit or delay generic market entry.

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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

Contact Information:
Phil Blando, 202-207-3614
Charles Coté 202-207-3605