DrugBenefitSolutions Highlights How PBMs Reduce Costs, Improve Quality

(Washington, D.C.) — As the independent drugstore lobby descends on Capitol Hill this week to promote costly new government health mandates, the Pharmaceutical Care Management Association (PCMA) is launching the next phase of its national campaign—DrugBenefitSolutions—highlighting how pharmacy benefit managers (PBMs) reduce prescription drug costs and improve benefits for consumers, employers, unions, and public programs.

Click here to visit DrugBenefitSolutions.com.

“PBMs will save consumers, employers, unions, and government programs $654 billion over the next decade,” said PCMA President and CEO Mark Merritt. “While independent drugstores play a vital role, their lobby’s agenda unfortunately would raise costs and undermine competition.”

The independent drugstore lobby agenda includes:

  • Eliminating Popular Preferred Pharmacy Plans in Medicare with So-Called “Any Willing Pharmacy” Mandates (H.R. 1939). These mandates would increase spending by $21 billion over 10 years, according to researchfrom The Moran Company examining the same legislation introduced previously. The Federal Trade Commission (FTC) wrote a letter to the Centers for Medicare and Medicaid Services (CMS) on “Any Willing Pharmacy” provisions and warned that: “Requiring prescription drug plans to contract with any willing pharmacy would reduce the ability of plans to obtain price discounts based on the prospect of increased patient volume and thus impair the ability of prescription drug plans to negotiate the best prices with pharmacies.”
  • Increasing Generic Medication Costs by Gutting the Use of Maximum Allowable Cost (MAC) lists (H.R. 1316). MAC lists are a key cost-savings tool that ensure payers aren’t overpaying pharmacies for generic drugs. Forty-five state Medicaid programs use MAC lists to reduce costs.   The Health and Human Services Office of Inspector General (OIG) touted “the significant value MAC programs have in containing Medicaid drug costs.”  The OIG also recommended that states strengthen MAC programs, not weaken them.  Likewise, a white paper authored by a former special counsel at the FTC notes that “legislative or regulatory measures that limit, restrict, or interfere with MACs are likely to have several unintended adverse consequences,” including higher prices and tacit collusion among pharmacies.
  • Raising Part D Premiums and Federal Government Costs by Hobbling the Use of Direct and Indirect Remuneration (DIR) (S. 413/H.R. 1038). While this bill might increase drugstore profits, it would raise premiums for beneficiaries and increase costs for taxpayers. A recent report by CMS highlights how DIR reduces premiums for beneficiaries, which also leads to lower costs for the federal government.