PCMA: New CMS Data Shows PBM Tools are Restraining Prescription Drug Costs


WASHINGTON, Dec. 7, 2017 — The Pharmaceutical Care Management Association (PCMA) released the following statement on the Centers for Medicare and Medicaid Services' (CMS) latest National Health Expenditure data:

“This report shows that even in the midst of rising drug prices PBMs are continuing to keep overall spending and out-of-pocket costs down.

Since one way plans reduce costs is by negotiating aggressive rebates and discounts from drug companies and drugstores, CMS should avoid new requirements on point-of-sale rebates or preferred pharmacy networks that make it harder for Part D plans to get these price concessions.

As CMS notes, requiring plans to estimate and apply manufacturer rebates at the point-of-sale would raise premiums by up to $28 billion and taxpayer costs by up to $82 billion over the next decade.” 

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.

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SOURCE Pharmaceutical Care Management Association

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