Washington, DC; 03.23.04 — With the Medicare Trustees’Report projecting that Medicare’s long-term viability is being endangered by rising health care costs across the program, the Pharmaceutical Care Management Association (PCMA) today called on policymakers to renew their commitment to preserving PBMs’ability to maximize savings on prescription drugs for both seniors and the Medicare program. PCMA is the national trade association representing America’s pharmaceutical benefit managers (PBMs).

“Today’s report by the Medicare Trustees is a sobering reminder to policymakers that the long-term viability of the Medicare program rests with increased choice and competition,”said PCMA President & CEO Mark Merritt. “More than ever, it is critical that policymakers move forward to implement the Medicare Modernization Act consistent with the goals of expanded choice and increased competition. We challenge policymakers from both sides of the political aisle to renew their commitment to preserving PBMs’ability to negotiate discounts and maximize savings on prescription drugs. Without PBMs participating in Medicare, seniors will likely pay more for prescription drugs and the burden to the program will only increase.”

Numerous independent government data and analyses have documented the value that competing PBMs can bring to the Medicare program. The Congressional Budget Office (CBO) has long asserted that PBMs have the potential to save as much as 30 percent in total drug spending relative to unmanaged purchases of prescription drugs where PBMs can use their full range of price discounts and rebates, utilization control tools, and other tools for encouraging appropriate utilization. CBO has also noted that they expect competing drug plans, including PBMs, to negotiate savings for many prescription drugs that are comparable to those obtained by the federal government through direct negotiation.

Other data also support the superior value that PBMs can bring to the system and help to rein in prescription drug costs. According to a January 2003 report by the US General Accounting Office, a comparison of drug pricing found that competing PBMs used by the Federal Employees’Health Benefits Program (FEHBP) saved enrollees more than state Medicaid programs that negotiate drug prices; on average, 7 percent more on the cost of brand-name drugs and 24 percent more on generic drugs when compared to five state Medicaid programs that negotiate drug prices.

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The Pharmaceutical Care Management Association (PCMA) is the national trade association representing America’s pharmaceutical benefit managers (PBMs). PCMA member companies provide pharmaceutical care management services to more than 200 million Americans.

Contact Information:
Phil Blando
202-207-3614