PCMA stresses on improving affordability in the health care system

Sep 11 2009

The Pharmaceutical Care Management Association (PCMA) issued the following statement on President Obama’s health care address before a joint session of Congress:

“Pharmacy benefit managers (PBMs) share the President’s goal of improving affordability as a central tenant to reforming the health care system. Tools pioneered by PBMs – including those which increase the use of generic medicines – have accomplished this goal by lowering costs and expanding access to prescription drugs for consumers and payers.

“As the Administration and policymakers explore additional options to help control costs, there are several policies that can accomplish this without restricting access to medications or shifting costs onto those who already enjoy drug benefits in private sector plans. These include:

• ‘Real’ Biogenerics Reform. Legislation allowing generics to compete with biotech medicines the way they do now with conventional brand-name drugs is one of the few proposals that actually delivers scoreable savings and could help finance broader health reform efforts. In contrast to some legislative proposals which seek to protect biotech monopoly pricing, meaningful biogenerics legislation is strongly supported by AARP, AFL-CIO, the Ford Motor Company, PCMA and dozens of other consumer, labor and employer organizations concerned about runaway health care costs in both the private and public sectors. Recognizing the need for increasing competition to lower biotech costs, the Administration has stated that offering seven additional years of ‘market exclusivity’ to the handful of companies who make biologics would be ‘generous.’
• Allowing Part D Plans to Negotiate Greater Discounts on all Drugs. Part D plans are required to cover ‘all or substantially all’ drugs in six or potentially more specially protected classes. PCMA strongly believes these Part D provisions eliminate price competition among manufacturers without providing seniors greater access to those drugs. Removing this requirement would save Medicare $4.2 billion over 10 years, according to the Centers for Medicare & Medicaid Services.
• Give Seniors Access to Home Delivery of Chronic Prescriptions. In addition, allowing greater use in Medicare of home delivery for refills of long-term, chronic medications would increase efficiency and save the government billions. Seniors appreciate the convenience and are more likely to stay on their drug regimens if their long-term maintenance medications are delivered right to their homes. Currently, due to restrictions in Medicare Part D, beneficiaries in private sector retiree plans use home delivery four times more often than those in Part D plans. This is costly and unfortunate since home delivery reduces costs and increases convenience for seniors and the disabled. Sadly, patients don’t fill more than 20 percent of those prescriptions which they are required to pick up at the drugstore.”