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Pharmacy Contracting & Reimbursement

July 19, 2016

PBMs contract with pharmacies on behalf of health plans and employers to serve patients by building networks of preferred pharmacies. As part of the negotiations to become a preferred network provider, pharmacies and PBMs negotiate contract types, payment rates for

If Drug Companies Had Their Way

August 7, 2023

If Drug Companies Had Their Way… There Would Be No Check on Their Power Download Infographic Patients Would Pay List Price for Drugs Drug companies often raise list prices annually in January and July. In January 2021, 822 brand drugs

Pharmacy Services Administrative Organizations (PSAOs) and their Little-Known Connections to Independent Pharmacies

January 19, 2021

The myth of the “go it alone” independent community pharmacy Most people believe that independent community pharmacies are individual “mom and pop” proprietorships standing alone in the face of drug manufacturers, pharmacy benefit managers (PBMs), and health plans. But the

PCMA Launches New Ad Campaign: President’s Executive Order Will Significantly Raise Medicare Premiums and Federal Spending

July 28, 2020

(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) is announcing the launch of a TV and digital advertising campaign on President Trump’s Executive Order to revive the so-called rebate rule. The campaign warns policymakers and the public that the

Pharma Boardroom: Washington Must Remain Focused on Root Cause of High Drug Prices

March 10, 2023

For millions of Americans, the prescription drug delivery system works: people, for the most part, can access the medications they need when they need them, and at the cost they expect and can afford. But “millions of Americans” does not

Brand Drug Manufacturers’ Anti-Competitive Behavior: Patent Thicket

May 11, 2021

Brand drug manufacturers use a variety of strategies to extend the exclusivity of their drugs beyond the end of their original 20-year exclusivity period. They use “patent thickets” as an extension tool by filing multiple additional patents on the same

PCMA Statement on Administration’s Executive Order on Prescription Drug Pricing

July 24, 2020

(Washington, D.C.) — Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott issued the following statement on the Administration’s Executive Order to resurrect the rebate rule. “The Administration’s decision last year to withdraw a proposed regulation on prescription drug

Podcast: The Impact of COVID-19 on the Pharmaceutical Market

July 6, 2020

JC Scott speaks with Doug Long, Vice President of Industry Relations at IQVIA, about the impact of COVID-19 on the pharmaceutical market. IQVIA is a world leader in using data, technology, advanced analytics and expertise to help customers drive healthcare

PBM Tools

September 15, 2021

PBM Tools PBM Tools Will Save Health Plan Sponsors and Consumers More than $1 Trillion on Prescription Drug Costs As prescription drug spending continues to increase, research shows PBMs’ cost savings and patient care management tools should reduce prescription drug

PBM Industry Principles

July 1, 2021

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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