New Loophole Exempting Drugstores from Safety, Performance Standards Raises Serious Concerns

Report: Bill Could Increase Health Costs by $6 Billion

Survey: Physicians Don't Think All Drugstores Have the 'Expertise and Capability' to Provide Certain Medicines

May 06, 2014, 12:20 ET from Pharmaceutical Care Management Association

WASHINGTON, May 6, 2014 /PRNewswire-USNewswire/ -- Legislation to exempt drugstores from certain safety and performance standards (S.3995-B and A.5723-B) raises patient safety concerns and, according to a new study, could increase prescription drug costs by $392 million in 2015 and $6 billion over the next decade. The study was conducted by the health research firm Visante for the Pharmaceutical Care Management Association (PCMA). 

The legislation would eliminate public and private health plans' ability to utilize mail-service and specialty pharmacies to effectively avoid medication errors, promote generics, improve adherence, and administer biologic medicines that can be injected or delivered intravenously.  A recent national survey of physicians who prescribe specialty medications found that just 5% believe that all drugstores "have the expertise and capability to provide the different types of specialty medications to patients."

"New, more complex medicines come to market every day and not all drugstores are equipped to safely administer every one of them.  Forcing plans to ignore this basic reality puts patients at risk and raises premiums," said PCMA President and CEO Mark Merritt

Major findings from the Visante study include: 

(Click here to read the study)

  • If enacted, the legislation could increase prescription drug costs and related medical costs in New York by up to $392 million in 2015. Over 10 years, the estimated cost could be $6 billion.
  • S.3995-B and A.5723-B would raise costs and undermine care in New York by exempting retail pharmacies from meeting standards related to credentialing, drug utilization evaluation activities, clinical prior authorization, quality-of-care reviews, and formulary compliance.
  • By reducing the effectiveness of pharmacy network contracts, S.3995-B and A.5723-B would undermine price concessions currently offered by mail-service and specialty pharmacies and result in higher costs.

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 216 million Americans.

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SOURCE Pharmaceutical Care Management Association