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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.

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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 Senate Finance Committee VoteNovember 08, 2023(Washington, D.C.) — The Pharmaceutical Care Management Association
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The Medicare Prescription Drug Rebate Rule

The Medicare Part D prescription drug benefit provides our nation’s seniors with affordable drug coverage, which is more important now than ever. The rebate rule clumsily attempts to eliminate the primary tool used by pharmacy benefit managers, or PBMs, to negotiate
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PBM Policy Forum 2021

With the public debate about prescription drug prices playing out in the press, in Congress, and among regulators, policymakers are focusing on the role of pharmacy benefit managers (PBMs) in addressing drug costs. Operating under contract with health plan sponsors
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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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