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Medicare Part D

Created by the Medicare Modernization Act of 2003, Medicare Part D provides a prescription drug benefit to Medicare enrollees. The Part D benefit is administered by private stand-alone drug plans and Medicare Advantage drug plans. Over the last decade, market-based
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Employers, Unions, & Insurers

PBMs administer prescription drug plans for more than 266 million Americans with health coverage provided through Fortune 500 employers, health insurers, and labor unions, as well as through public programs such as Medicare and Medicaid. A common thread connecting all programs
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Drug Abuse Prevention

PCMA supports the creation of “Safe Pharmacies” in Medicare Part D for Controlled Prescription Drugs. The creation of “Safe Pharmacies,” or a “Lock-In” program in Part D for controlled substances, will allow Part D plans to require at-risk beneficiaries to
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Value & Outcomes-Based Contracting

PBMs and payers are committed to the affordability and sustainability of the healthcare system and recognize the importance of aligning reimbursement around value instead of volume. Traditionally, risk-sharing agreements between payers and drug manufacturers have not been tied to the
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Fraud, Waste, & Abuse

PBMs employ a variety of state-of-the-art techniques when working with pharmacies and other stakeholders to combat fraud, waste, and abuse. Vigilance against fraud is paramount to ensure that scarce health care resources are used for legitimate purposes. According to PCMA-sponsored
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COVID-19: How PBMs Are Helping Patients and Health Plans

COVID-19: Principles on Patient Access to Prescription Drugs During this public health emergency, PBMs are committed to helping the patients we serve practice social distancing and stay at home safely with convenient, reliable access to their needed prescription drugs. As
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Policies To Reduce Prescription Drug Costs in 2021

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 266 million Americans who have health coverage from a variety of sponsors. PCMA continues to lead
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Annual Meeting 2018

The PCMA Annual Meeting is the industry's premier executive conference. The event is tailored specifically for senior executives from PBMs and their affiliated business partners - most notable drug manufacturers. We've designed the Annual Meeting to be an important part of
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Final design

PBMs: Committed to Helping Patients The Critical Path Forward: Rx Policies to Reduce Patient Costs, Improve Access For America’s pharmacy benefit managers, PBMs, our core mission is to increase access to affordable prescription drugs for all Americans. But more can

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