August 1, 2011
(Washington, DC)—Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt released the following statement today on a new Government Accountability Office (GAO) report, “Medicare Part D Formularies: CMS Conducts Oversight of Mid-Year Changes; Most Mid-Year Changes Were Enhancements”:
“While experts agree that pharmacy benefit managers (PBMs) help Part D come in under budget each year, GAO’s new report provides fresh evidence that the Medicare drug benefit also expands access to new medications.
“GAO finds that 90 percent of the mid-year changes plans make to formularies are enhancements like covering a new drug. In the few cases when a drug is no longer covered, it’s usually because a generic version of that drug has become available.
“This is in stark contrast to Medicaid’s expensive, fee-for-service approach to pharmacy, which contributes to spiraling deficits in states all across America.
“According to a recent report, states and the federal government could save $33 billion – without cutting benefits for patients or payments to doctors and hospitals – by bringing Medicaid pharmacy benefits into the 21st century.”