"In health care, people want better care and lower costs. Specialty pharmacies and preferred pharmacy networks accomplish both," said PCMA President and CEO Mark Merritt.
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Lower cost, preferred pharmacy plans are the foundation of the popular Medicare Part D program. An analysis of CMS Part D 2016 enrollment data finds that 75 percent of Medicare beneficiaries chose preferred pharmacy plans that offer convenient access and extra discounts at certain pharmacies. An actuarial study from Milliman concludes that preferred pharmacies will reduce federal Medicare Part D costs up to $9.3 billion during the next 10 years.
Specialty pharmacies administer complex biologic medicines, many of which are infused intravenously. They also reduce medication errors, manage and prevent side effects, and promote more affordable alternatives. A new white paper from sPCMA notes that "specialty pharmacies must offer a full range of clinical and operational services to enhance the safety, quality, and affordability of care for patients receiving specialty medications." Physicians who prescribe specialty medications are highly satisfied with specialty pharmacies and do not think most drugstores have the "expertise and capability" to provide specialty medications to patients, according to a national survey.
PBMs are projected to save employers, unions, government programs, and consumers $654 billion — up to 30 percent — on drug benefit costs over the next decade, according to new research from Visante. PBMs reduce drug costs by:
- Offering Amazon-style home delivery of medications and creating select networks of more affordable pharmacies;
- Encouraging the use of generics and more affordable brand medications;
- Negotiating rebates from drug manufacturers and discounts from drugstores;
- Managing high-cost specialty medications; and
- Reducing waste and improving adherence.
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 insurance from a variety of sponsors including: commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, managed Medicaid plans, and others.
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SOURCE Pharmaceutical Care Management Association