(Washington, DC)— The Pharmaceutical Care Management Association (PCMA) today released its 2008 policy agenda that promotes pharmacy benefit management (PBM) tools that provide affordability and choice on prescription drugs for consumers and payors.

“We believe that competition and 21st century innovation are the keys to generating savings and access for prescription drugs,” said PCMA President and CEO Mark Merritt. “Issues such as electronic prescribing and biogenerics will continue to gain bipartisan support. Meanwhile, issues which increase the cost of prescription drugs, such as collective bargaining and so-called ‘prompt pay’ bills, will be increasingly difficult for ‘budget hawks’ to support.”

PCMA’s 2008 Policy Agenda

Opposing Bills That Would Increase Prescription Drug Costs. In Medicare Part D, PCMA will continue to promote the utilization of proven PBM tools that have helped lower program costs 30 percent below initial government projections, generated more generic utilization than Medicaid, and provided greater choice of drugs and pharmacies than the Veterans’ Administration program. PCMA will also continue to aggressively oppose bills that would increase prescription drug costs for consumers and payors. Some of these proposals include:

• Mandating “Prompt Pay” of Medicare Claims. PCMA member companies currently pay claims within 30 days, a standard consistent with Medicare Parts A & B, the federal employees’ health plan, and the private sector. Legislation that would make Medicare prescription drug plans (PDPs) pay drugstores twice as fast as Medicare pays other providers could cost the program and its beneficiaries at least $3.1 billion over the next decade. The independent drugstore lobby’s own Medicare prescription drug plan paid in a 30-day cycle. Furthermore, many independent drugstores also hire Pharmacy Service Administrative Organizations (PSAOs), middlemen that serve as billing intermediaries between payors and themselves. Often independent drugstores require payors to send reimbursements to PSAOs—which in turn process and forward payments to pharmacies. This ‘middle step’ could be delaying payments.
• Sweeping Antitrust Exemptions for Independent Pharmacies. PCMA will also continue to combat legislation that would grant ind ependent pharmacies exemptions from antitrust laws, allowing them the right to collude and raise prescription drug prices. The pharmacy antitrust exemptions in HR 971 would increase prescription drug costs for Medicare and commercial payors by up to 11.8 percent or $29.6 billion over five years, according to an analysis from CRA International.
• Electronic Prescribing (E-Prescribing) in Medicare. In 2008, PCMA will continue its campaign to ensure full adoption of e-prescribing in Medicare. PCMA supports the bipartisan “Medicare Electronic Medication and Safety Protection (E-MEDS) Act of 2007″ introduced in December by Senate Finance Committee Members John Kerry (D-Mass.) and John Ensign (R-Nev.). Companion legislation was introduced in the House by Representatives Allyson Schwartz (D-Penn.) and Jon Porter (R-Nev.). This legislation would save lives and money and enjoys support from a broad coalition of consumers, unions, businesses, purchaser groups, and other prescription drug stakeholders.

Fighting for Generic Alternatives.

The Need for Biogeneric Competition. PCMA will once again drive the issue of creating of a clear regulatory pathway for biogenerics. With spending on biologics expected to double from $54 billion to $99 billion by 2010, PCMA strongly believes injecting competition in this space is necessary in order to drive down costs and increase access for consumers and employers.

Fighting Efforts that Prevent Generic Substitution. Generic substitution, as permitted by current state laws, is a well-established, clinically-sound practice. However, brand-name drug manufacturers continue their efforts to prevent generic substitution by adding unnecessary administrative requirements on pharmacists in states across the country. PCMA strongly opposes any unnecessary burdens that would inhibit access to prescription drugs that provide significant cost-savings to consumers, health plans, and e mployers.

Supporting Comparative Effectiveness. PCMA also believes that comparing the clinical effectiveness of competing drug therapies is an important tool to promote value-based purchasing. PCMA supports funding for the Agency for Healthcare Research and Quality (AHRQ) and believes that policy makers should explore collaborative opportunities in the public and private arenas where comparative effectiveness can successfully be implemented.

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PCMA is the national association representing America’s pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 210 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.

Contact Information:
Charles Coté 202-207-3605