E-Prescribing Saves Lives, Improves Quality

(Washington, DC)- The Pharmaceutical Care Management Association (PCMA) issued the following statement on the final Medicare electronic prescribing (e-prescribing) rule released yesterday by the Centers for Medicare & Medicaid Services (CMS).  The final rule rewards physicians and other eligible professionals who adopt this life-saving technology with bonus payments starting in 2009:

“Securing full physician adoption of e-prescribing as soon as possible is critical to improving safety, savings, and quality in our health care system.

“PCMA applauds the final rule from CMS which establishes an important framework in providing sufficient reimbursements for physicians to adopt e-prescribing and maintaining uniform standards that have been accepted by all stakeholders.” 

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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.

PCMA: Even Greater Savings Opportunities Available with

Mail-Service Pharmacies, E-Prescribing, and Biogenerics 

(Washington, DC)-The widespread use of generic prescription drugs and other proven pharmacy benefit management tools in Medicare Part D has resulted in the program coming in 30 percent under original budget projections.  However, even greater savings opportunities are available for the program, the Pharmaceutical Care Management Association (PCMA) said today.

“In a time of economic turmoil and massive government deficits, the Medicare prescription drug benefit offers one example of a government program that is actually saving money,” said PCMA President and CEO Mark Merritt. “The program can save even more in years to come if more consumers use cost-saving mail-service pharmacies, if more physicians use e-prescribing technology, and if Congress passes legislation enabling the FDA to approve generic versions of expensive biotech medicines.  Congress must also resist new initiatives that would actually increase drugs costs, such as the proposal to give white collar pharmacists the right to collectively bargain for higher prices.”

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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.

E-Prescribing Saves Lives, Improves Quality

(Washington, DC)- The Pharmaceutical Care Management Association (PCMA) released the following statement on a new analysis of federal data by the Institute for Safe Medications that found the Food and Drug Administration (FDA) has received a record number of reports of serious drug reactions, including more than 4,800 deaths:

“This new analysis reinforces the Institute of Medicine’s (IoM) recommendation that all physicians begin prescribing electronically by 2010 to help prevent the 1.5 million harmful medication errors that occur annually. Securing full physician adoption of e-prescribing as soon as possible is critical to improve safety and quality in our health care system.

“A new law in Medicare addresses this issue by providing incentives for physicians to use e-prescribing for America’s seniors.” 

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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.

Generics, Mail-Service Pharmacy and E-Prescribing Provide Real Savings  

(Washington, DC)- Today’s New York Times piece (“Some Cut Back on Prescription Drugs in Sour Economy”) highlights the need to choose generics, mail-service pharmacies, electronic prescribing (e-prescribing) and other proven pharmacy benefit management tools that provide savings on prescription medicines, the Pharmaceutical Care Management Association (PCMA) said today.

“Consumers should explore available prescription drug cost-saving options, including generics and mail-service pharmacies,” said PCMA President and CEO Mark Merritt.  “Patients can save even more if they find a doctor who uses e-prescribing, which shows when more affordable options are available.”

The use of generics typically lowers costs from 30 to 80 percent.  Mail-service pharmacies also provide increased savings and patient compliance. 

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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.

 ‘Collective Bargaining’ Legislation Unnecessary

(Washington, DC)- The Pharmaceutical Care Management Association (PCMA) released the following statement on the 2008 NCPA Digest that confirms special collective bargaining legislation for independent pharmacies is unnecessary:

“The independent drugstore lobby’s new research shows that independent pharmacies are ‘adjusting to new market conditions’ and are ‘successful in sustaining their viability.’  The increased profits and salaries at independent drugstores show that their business model is strong.  This further highlights that we don’t need to create new ‘collective bargaining’ legislation that would empower independent drugstores to charge higher prices to consumers and payors.

“Recently, the Congressional Budget Office (CBO) found that HR 971 would increase federal costs by $640 million over ten years and that increased drug costs to private health plans, employers, and consumers would result in ‘reductions in the scope or generosity of health insurance benefits, such as increased deductibles or higher copayments.’  CBO’s analysis also contends that cost increases resulting from the legislation would be passed along to workers, reducing ‘both their taxable compensation and other fringe benefits.’

“Furthermore, during testimony on HR 971 before the House Judiciary Committee Antitrust Task Force, the Federal Trade Commission (FTC) stated: ‘Giving heath care providers . . . a license to engage in price fixing and boycotts in order to extract higher payments from third-party payers would be a costly step backward, not forward, on the path to a better health care system.’”  

Bargaining Tools Already Available to Independent Drugstores

Independent pharmacies currently enjoy numerous bargaining tools to gain market power in government and commercial programs, including:

• Independent pharmacies often participate in joint purchasing groups that allow them to lower costs and compete more effectively.
• Both Medicare and private insurers require geographic pharmacy network access standards for their enrollees that already provide pharmacies-particularly rural pharmacies-extensive negotiating power with PBMs.
• All health care providers, including pharmacies, can form joint ventures with other pharmacies to provide quality and clinical services and negotiate the fees for those services.

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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

“Generic Carve-Out” Legislation Ignores Existing Laws in All 50 States 

FDA, Medical Groups, and Others Support Generic Substitution 

(Washington, DC)- Legislative proposals to exempt certain classes of drugs from generic substitution laws would increase costs by more than $29 billion over ten years if enacted nationally and provide no safety or clinical benefit for patients, according to a study conducted by the healthcare consulting firm Visante for the Pharmaceutical Care Management Association (PCMA).

“In this economy, the worst thing you can do is pursue policies which increase the cost of prescription drugs for payors and patients alike.  The Food and Drug Administration, medical groups, and others maintain that generic substitution for all drug classes is safe and clinically appropriate,” said PCMA President and CEO Mark Merritt.  “So called ‘generic carve-out’ legislative proposals that would grant special protections to brand name drug manufacturers would have no clinical benefit for patients and would unnecessarily increase costs for consumers and payors by $29 billion in the coming decade.”

Generic carve-out legislation would undermine the ability of pharmacists to substitute generic drugs in place of brand versions in certain drug classes. Many brand name drugs in these classes will soon face generic competition, according to Visante.  Carve-out measures would protect these brands from competition by forcing pharmacists to contact prescribers for consent before substituting the generic, even when the prescriber has not indicated that a brand is medically necessary.  This burdensome requirement runs counter to existing laws in all 50 states and could cause harmful delays for patients in need of their medications.

In 2008, more than 57 generic carve-out bills were introduced in 27 states.  Forty-four of those bills have died thus far this year in 21 states. Based on a comprehensive literature review and an analysis of prescription claims data from four national pharmacy benefit managers (PBMs) managing benefits for some 165 million Americans, Visante finds:

• Generic carve-out legislation runs counter to the opinion of the Food and Drug Administration (FDA), which has repeatedly stated that generic drugs can be expected to have the same clinical effects as their brand counterparts and encourages generic substitution across all therapeutic categories, including medications in the antiepileptic, immunosuppressant, and antipsychotic classes.
• If generic carve-out legislation were enacted nationally in 2009 in the antiepileptic, immunosuppressant, and antipsychotic therapeutic classes, total prescription drug costs to Medicaid, commercial payors, and consumers would increase by $29 billion over the 2010-2019 period.
• Nationally enacted carve-out legislation would increase drug costs to commercial payors by $17.5 billion, Medicaid by $6.2 billion, and consumers by $5.3 billion over ten years.

PBMs encourage generic drug utilization by implementing programs such as lower or waived copayments for generics, clinical step therapy protocols, as well as patient and prescriber outreach. Coupled with generic substitution laws, such programs have resulted in the typical generic substitution rate exceeding 90 percent. With generic carve-outs, new generic entries would capture only 25 percent of the market previously held entirely by their respective brand equivalents, according to Visante. 

To be conservative, Visante only measured the impact of generic carve-out legislation on new generic drugs since it would be more difficult for new generics to gain market share in the face of prescriber consent requirements. Visante also suggests that carve-out legislation could impact the use of older generic drugs, since the vast majority of prescriptions for such products are still written by prescribers using the medication’s brand name.

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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.

Undermining Generic Drug Substitution: The Cost of Generic Carve-Out Legislation