(Washington, DC)—In the aftermath of Katrina, America’s pharmacy benefit managers (PBMs) and other health care leaders relied on electronic prescribing (e-prescribing) technology to provide over 800,000 people with medications once their paper prescription records had been lost. On this second anniversary of Katrina, the Pharmaceutical Care Management Association (PCMA) calls on Congress to enact legislation that would guarantee Medicare beneficiaries access to the safety and savings benefits associated with e-prescribing.

When Katrina hit, nearly 40 percent of Gulf Coast evacuees had prescriptions which were lost, left behind, or otherwise destroyed in the disaster. Patients with heart disease, diabetes, and other life-threatening illnesses were dependent on their medications for survival, but paper prescriptions and paper medication history information were no longer available. Fortunately, many patients had access to medication history through electronically prescribed and stored information allowing continuity of care and preventing unnecessary medication errors.

Without the critical medication history information electronic prescribing provided, relief workers would have been forced to play a dangerous guessing game about which medications these victims truly needed. Electronic prescribing technology ensures that patient prescribing history can be shared securely and quickly in the event of a disaster. It also reduces medication errors in the routine setting of everyday life â?? the doctor’s office—where most people get their prescriptions.

By requiring e-prescribing in Medicare, Congress can take a positive lesson learned from Katrina relief efforts and ensure that America’s seniors have access to the safest, most reliable technology in prescribing today.

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PCMA is the national association representing America’s pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 210 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.

Contact Information:
Charles Coté 202-207-3605

E-Prescribing in Medicare Would Improve Medication Adherence, Lower Costs

(Washington, DC)—The Pharmaceutical Care Management Association (PCMA) issued the following statement on a Fall 2006 survey examining the Medicare Part D program that was published in Health Affairs today:

“According to this survey, there has been a dramatic reduction in the number of seniors without drug coverage prior to the enactment of Part D. However, one problem that persists is that some seniors are not filling, or are delaying filling their prescription medications due to costs.

“Requiring e-prescribing in Medicare would improve medication adherence by alerting physicians and patients when clinically sound, yet more affordable drugs are available to treat specific conditions. Currently, neither seniors nor their doctors are aware of their full range of pharmacy options, including generic drugs, less expensive brand name alternatives, and the more affordable mail-service pharmacy option. Furthermore, e-prescribing could prevent up to 1.9 million medication errors, saving beneficiaries and the federal government billions over the next decade.

“Existing proven pharmacy benefit management tools—including the increased use of generics and the mail-service pharmacy option—are generating savings on average of 29 percent compared to retail purchases with no pharmacy benefit management support. Earlier this year, PricewaterhouseCoopers (PwC) found that the use of these proven tools in Part D will save beneficiaries and the program $693 billion over the 2008 to 2017 period, including $43 billion in reduced prescription drug costs in 2008 alone.”

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PCMA is the national association representing America’s pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 210 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.

Contact Information:
Charles Coté 202-207-3605

Physicians Treating Minnesota State Employees Must Use E-Prescribing by 2011

(Washington, DC)—In a signal of momentum for greater use of e-prescribing by America’s physicians, the state of Minnesota has taken steps to require physicians contracting with the state employee health plan’s medical networks to use e-prescribing by 2011, said the Pharmaceutical Care Management Association (PCMA) today.

Last year the Institute of Medicine challenged all physicians to begin using e-prescribing to reduce the 1.5 million preventable medication errors that occur each year due to causes such as harmful drug-drug interactions, unawareness of patients’ medication history and illegibly written prescriptions.

“Governor Pawlenty’s Administration is the first to make sure that more doctors take advantage of the safety and savings benefits of e-prescribing. This is a refreshing antidote to the ‘all talk, no action’ approach that too often accompanies this important issue,” said PCMA President & CEO Mark Merritt. “Unfortunately less than one in ten physicians use e-prescribing and two-thirds are not making it a priority to begin doing so. The Pawlenty Administration’s initiative will help fix this problem in Minnesota.”

Merritt noted that e-prescribing also saves patients and payers money by giving doctors real-time, online access to their patients’ full range of pharmacy choices, including more affordable brand and generic options. Without e-prescribing, neither doctor nor patient typically knows this information before a prescription is written.

On a national level, PCMA urges Congress to require e-prescribing in Medicare, too. A recent study conducted by the Gorman Health Group noted that doing so would reduce 1.9 million medication errors and save billions of dollars over the next decade.

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PCMA is the national association representing America’s pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 210 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.

Contact Information:
Charles Coté 202-207-3605

(Washington, DC)— According to new data released by the Centers for Medicare & Medicaid Services (CMS), the 2008 average beneficiary premium for standard Part D coverage is roughly $25, a figure far lower than the $41 figure that was originally estimated in 2003. The relatively stable premium figure confirms the success of Medicare prescription drug plans’ (PDPs) ability to continue providing savings and access for beneficiaries in Part D, said the Pharmaceutical Care Management Association (PCMA) today.

The Part D average premium of roughly $25 for basic coverage is 40 percent lower than what was originally forecasted when the program was established. The premium for basic coverage did increase slightly from $22 in 2007 to $25 in 2008. According to CMS, that slight increase was “due primarily to technical adjustments required by law rather than increased bids.”

“Part D sponsors continue to exceed expectations in terms of the savings, choice and satisfaction they offer to America’s Medicare beneficiaries,” said PCMA President Mark Merritt. “In 2008, many beneficiaries will be able to choose a plan that offers the same or even lower premiums than they had in 2007— while still enjoying tremendous access to the medications they need.”

Numerous surveys show that beneficiaries have high satisfaction with the program. It is generating deep discounts, while also providing broad access to necessary prescription medicines. According to CMS, beneficiaries in Part D are saving an average of $1,200 compared to those without coverage, while the program is 30 percent less expensive for the first ten years than originally estimated.

In addition, several other reports have illustrated the savings beneficiaries are enjoying in Part D. According to a recent study by IMS Health, Part D lowered out-of-pocket costs for previously uninsured seniors by 60 percent per prescription. Earlier this year, PricewaterhouseCoopers (PwC) found that PBM tools in Part D are estimated to save beneficiaries $693 billion over the 2008 to 2017 period, including $43 billion in reduced prescription drug costs in 2008 alone.

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Contact Information:
Charles Coté 202-207-3605

(Washington, DC)— The Pharmaceutical Care Management Association (PCMA) issued the following statement today on new Average Manufacturer Price (AMP) legislation introduced by Senate Finance Chairman Max Baucus (D-Mont.):

“PCMA applauds Senator Baucus’ effort to remove mail-service pharmacy rebates from inclusion in AMP.

“While supportive of the exclusion of PBM retail business rebates and discounts from inclusion in the final AMP rule issued last month by the Centers for Medicare & Medicaid Services (CMS), we are concerned that mail-service and specialty pharmacy remain included. PCMA believes the legislation introduced by Senator Baucus gets us one step closer to the original intent of the Deficit Reduction Act, which was to ensure continued access to retail pharmacies while also appropriately defining retail class of trade.

“PCMA looks forward to working with Senator Baucus and other Members of Congress that have introduced similar legislation to ensure adequate Medicaid reimbursements.”

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Contact Information:
Charles Coté 202-207-3605

Previously Uninsured Seniors Saving on Average 60 Percent on Medicines

(Washington, DC)—A key benchmark of plan performance—the use of generic medications—is higher in Medicare Part D than in the rest of the marketplace, according to a new report from IMS Health, a global pharmaceutical and healthcare consulting firm. Part D plans have also helped previously uninsured seniors to reduce their out-of-pocket costs by 60 percent per prescription according to IMS, said the Pharmaceutical Care Management Association (PCMA) today.

The new IMS report—Medicare Part D: The First Year—examines the impact of Part D on medication use among seniors. Specifically, IMS finds:

• Generic drugs comprise 58 percent of prescriptions in Part D, compared to 57 percent of all retail prescriptions;
• In Part D, patient compliance with therapies for chronic conditions increased in 4 out of 5 therapeutic categories;
• Previously uninsured seniors in Part D increased their use of all medications—including both generics and brands—by 26 percent while their out-of-pocket costs per prescription decreased by 60 percent;
• Seniors switching from third-party coverage to Part D increased their prescription use by 10 percent, while their out-of-pocket drug costs decreased by 17 percent; and
• Only 6 percent of enrollees entered the donut hole, and a sizable portion of those enrollees did so in the final days of the year.

“PBMs have played a key role in increasing generic utilization in Part D,” said PCMA President Mark Merritt. “This new report is further evidence that Part D plans and the PBMs who administer them are reducing costs and increasing access for America’s seniors and the disabled.”

In addition to the most recent data from IMS, a study earlier this year from PricewaterhouseCoopers (PwC) found that proven pharmacy benefit management tools in Part D are estimated to save beneficiaries $693 billion over the 2008 to 2017 period, including $43 billion in reduced prescription drug costs in 2008 alone.

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Contact Information:
Charles Coté 202-207-3605

(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.”

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Contact Information:
Charles Coté 202-207-3605