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Pharmacies feel stiffed on COVID pill payments

PCMA pointed to a blog post written by CEO JC Scott, which said PBMs are “voluntarily paying dispensing fees for these drugs, which are not technically covered by Medicare and other insurance,” and “most PBMs are paying standard or Medicaid-level” fees.

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PBM Policy Forum 2018

Pharmacy benefit managers are at the forefront of implementing innovative contracting techniques that better align the cost of medications with their value. By offering additional tools to manage specialty drugs, including the use of specialty pharmacies, PBMs and payers are
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Pharmacies feel stiffed on COVID pill payments

PCMA pointed to a blog post written by CEO JC Scott, which said PBMs are “voluntarily paying dispensing fees for these drugs, which are not technically covered by Medicare and other insurance,” and “most PBMs are paying standard or Medicaid-level” fees.

Read More »

Covid Pill Dispensing Costs Push Pharmacies to Call on Medicare

The Pharmaceutical Care Management Association, which represents the pharmacy middlemen that help decide how a drug will be covered by insurance, said in an email that its members are “stepping up to support the government’s efforts” to provide effective Covid-19 treatments and that they are “making voluntary payments to pharmacies in order to maintain appropriate access to the medications for patients.”

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PBM Industry Principles

PBM Industry Principles PBMs have distinct business processes that differentiate them in the market, but PBMs also adhere to stringent accreditation standards, the terms of negotiated contracts, and legal requirements. In support of our health plan sponsor clients, we are
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News & Media

MEDIA CENTER For press inquiries, contact Charles, Greg or Mike. Charles Coté ccote@pcmanet.org 202-756-5712 Greg Lopes glopes@pcmanet.org 202-756-5713 Mike Baldyga mbaldyga@pcmanet.org 202-756-5714 Press Releases PCMA Statement On House Vote Of H.R. 5378December 11, 2023The Pharmaceutical Care Management Association (PCMA) released
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PCMA-Connect

PCMA-Connect is an invitation-only LinkedIn Group and online networking community for PCMA members, affiliates, and registered conference attendees. As those familiar with PCMA conferences know, our sessions address the most insightful and relevant industry issues and our business networking opportunities are
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Drug Cost Management

The management of high cost drugs is receiving increased attention from patients, providers, payers, and policymakers due to ongoing drug price increases and the aggregate impact on health care costs. PBMs are responsible for creating novel solutions to improve the quality
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