PCMA: Medicare Trustees Report Shows PBMs are Delivering Savings in Part D Merritt: Generics, Pharmacy Networks Are Reducing Premiums for Beneficiaries

WASHINGTON, May 31, 2013 /PRNewswire-USNewswire/ -- According to a report released today by the Medicare Trustees, Part D costs in 2012 were 13 percent lower, while beneficiary premium payments were 14 percent lower than previously projected.  The tools utilized by Medicare Part D plans—including preferred pharmacy networks and generic alternatives—are delivering savings, the Pharmaceutical Care Management Association (PCMA) said today.

"PBMs promote generics, create affordable pharmacy networks, and use other tools to reduce costs in Medicare Part D," said PCMA President and CEO Mark Merritt. "Policymakers should promote greater use of these tools and reject rules and regulations that would make it harder to save money in Part D."

While preferred physician and hospital networks have long been used to reduce costs, there is a growing understanding of the cost-savings potential of pharmacy networks. Today, there are more drugstores in the U.S. than McDonald's, Burger Kings, Pizza Huts, Wendy's, Taco Bells, Kentucky Fried Chickens, Domino's Pizzas, and Dunkin' Donuts combined, creating a highly competitive environment.  

Greater use of preferred and limited pharmacy networks could save Medicare an additional $35 billion over the next ten years while meeting the program's pharmacy access standards, according to a recent study. More than 40% of Part D seniors (9.5 million) are currently enrolled in plans with preferred networks.

A new survey from Hart Research Associates also finds that Medicare Part D seniors are overwhelmingly satisfied (85%) with their preferred network plan. Key findings from the survey of seniors about their Medicare Part D preferred network plan include:

  • Four in five seniors (80%) would be disappointed if their preferred network plan is eliminated.
  • Seniors are overwhelmingly satisfied (85%) with their preferred network plan.
  • The cost of premiums (50%) and copays (48%) are the most important considerations for seniors in selecting their preferred pharmacy plan. 
  • Increased costs is the most common reason seniors would be disappointed if their preferred network plan is eliminated.
  • Seniors are very satisfied with the convenience of pharmacies (81%), the number of pharmacies in their network (74%), and the prescription medications available through their plan (75%).
  • Cost is the top factor for seniors regardless of income, age, number of medications, and distance from their drugstore.
  • Only 8% of seniors listed the number of pharmacies in the network as an important consideration.

Click here to read the survey.

PCMA represents the nation's pharmacy benefit managers (PBMs), which improve affordability and quality of care through the use of electronic prescribing (e-prescribing), generic alternatives, mail-service pharmacies, and other innovative tools for 210-plus million Americans.

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SOURCE Pharmaceutical Care Management Association



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