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PCMA "PBM Policy Forum" Addressing Drug Pricing and Improving Quality


News provided by

Pharmaceutical Care Management Association

May 01, 2017, 12:11 ET

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WASHINGTON, May 1, 2017 /PRNewswire-USNewswire/ -- Today, the Pharmaceutical Care Management Association (PCMA) holds its annual "PBM Policy Forum" at the Newseum in Washington, D.C. This year's event focuses on harnessing competition to reduce drug costs as well as the innovative clinical programs and pharmacy expertise that pharmacy benefit managers (PBMs) provide to patients, pharmacists, and physicians to improve quality of care and lower costs.

"This forum will explain how PBMs are able to simultaneously reduce costs and improve the quality of prescription drug benefits," said PCMA President and CEO Mark Merritt.

Typically, PBMs reduce drug costs by 30 percent for more than 266 million Americans enrolled in private and public plans, most notably Medicare Part D. Learn more about how PBMs reduce costs and improve quality at DrugBenefitSolutions.

Featured speakers at the forum include:

  • William Fleming, Segment President, Healthcare Services, Humana Inc.
  • Mark Merritt, President & Chief Executive Officer, PCMA
  • Surya Singh, Corporate Vice President & Chief Medical Officer, CVS/Specialty, CVS Health
  • Amy Bricker, Vice President, Supply Chain Product and Strategy, Express Scripts
  • Alex Brill, CEO of Matrix Global Advisors and Research Fellow, American Enterprise Institute  
  • Dan Gilman, Attorney, Advisor, Federal Trade Commission, Office of Policy Planning
  • Mary Sumpter Lapinksi, Special Adviser to the Secretary, U.S. Department of Health and Human Services
  • Mark Miller, Executive Director, MedPAC

In conjunction with today's forum, PCMA is releasing a new white paper highlighting PBMs' role in providing clinical value to providers and patients and reducing prescription drug costs. The white paper – PBMs provide clinical value to patients, doctors and other healthcare providers – outlines PBMs' ability to offer critical clinical services in an evolving health care landscape, including:

  • Monitoring drug safety through FDA-approved Risk Evaluation and Mitigation Strategies (REMS) programs;
  • Managing drug-related side effects, engaging in adherence and persistency support;
  • Providing ongoing clinical support directly to patients and their caregivers;
  • Improving patient clinical outcomes; and
  • Proving population health-focused information and patient support.

Click here to read the white paper.

In addition, the forum will include a discussion around a recent white paper from Alex Brill, CEO of Matrix Global Advisors that identifies five policy priorities for the new commissioner that would promote greater prescription drug competition. Click here to read the new white paper.

The report recommends five ways the FDA could foster competition and help reduce prescription drug costs:  

  • Encourage "First Generic" Applications. The FDA should reduce the review time for first generics – that is, generics for products that do not yet have a generic equivalent.
  • Prevent Misuse of Risk Evaluation and Mitigation Strategies (REMS) Programs. Congress must give the FDA authority to prevent the misuse of REMS programs. Some brand manufacturers use these programs to deny access to drug samples for manufacturers who want to develop generic versions of brand products.
  • Reduce Barriers to Generic Entry. The FDA should reduce the review period for standard ANDAs and ensure that generic user fees do not discourage firms from seeking approval for generic drugs.
  • Dedicate More Resources to Brand-to-Brand Competition. Improve operational processes inside the FDA and, if necessary, provide more resources for the agency to expedite approvals for competing brand products.
  • Streamline the Application Process for Biosimilars. The FDA should carefully review biosimilar guidance and regulations and look for ways to facilitate the application process and reduce review times. The agency should also provide additional clarity and predictability to stakeholders on biosimilar interchangeability.

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, Medicaid plans, and others.

SOURCE Pharmaceutical Care Management Association

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