The Pharmaceutical Care Management Association (PCMA) is the national association representing America’s pharmacy benefit managers (PBMs) PBMs administer prescription drug plans for more than 253 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.
PCMA continues to lead the effort in promoting PBMs and the proven tools they utilize, which are recognized by consumers, employers, policymakers, and others as key drivers in lowering prescription drug costs and increasing access.
PBMs will save consumers and payers almost $2 trillion in prescription drug costs – a 35 percent savings – over the next decade, according to research from Visante. The research also indicates that another $550 billion could be saved if payers used the full array of savings-tools that PBMs offer.
The tools and techniques pioneered by PBMs include:
- Electronic prescribing (e-prescribing)
- Mail-service pharmacy;
- Pharmacy and therapeutic (P&T) committee formulary development and review;
- Pharmacy network management;
- Negotiation and administration of product discounts, including manufacturer rebates;
- Generic substitution;
- Drug utilization review (DUR)
- Clinical prior authorization and step therapy;
- Consumer and physician education;
- Disease management; and
- Consumer compliance programs.