PBM companies vary in size, geographic footprint, and service offerings, which creates a marketplace with a variety of options for health insurers, employers, labor unions, government programs, and other health plan sponsors. As of March 2023, there are 73 full-service
The Medicare Prescription Drug Rebate Rule PCMA Urges Congress to Permanently Repeal Rebate Rule This Year 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
(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) today announced a set of industry principles that outline how pharmacy benefit managers, PBMs, interact with employer clients and other prescription drug coverage sponsors to provide clear, transparent contracting and deliver affordable pharmacy
A recent blog (“Payers and PBMs Profit from Obscure Pharmacy Fees, While Seniors See No Relief in Prescription Costs”) suggests performance-based price concessions are retained by PBMs, restrict the growth of independent pharmacies, and inflate Medicare Part D enrollee’s out-of-pocket costs—unfounded
This week, the U.S. Senate Health, Education, Labor & Pensions (HELP) Committee considers legislation that would lower choice in the market by creating a one-size-fits all pharmacy benefit contracting model for health plans and employers. As Congress considers mandating contracting
New Paper Finds Potential Cost Savings from Adalimumab Biosimilars are Significant but Competitive Market Will Take Time The Pharmaceutical Care Management Association (PCMA) agrees that biosimilars bring more competition to the prescription drug marketplace, which is critical to lowering costs
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
(Washington, D.C.) — Today, representative organizations of America’s pharmaceutical supply and payment chain, including prescription and over-the-counter brand and generic manufacturers; wholesalers; retail, specialty, and managed care, pharmacies; health insurance providers and other payers; pharmacists in hospitals and health systems; and
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