February 19, 2020
(Washington, D.C.) — As prescription drug spending is poised to reach as much as $5 trillion during the next decade, new data find that pharmacy benefit managers’ (PBMs’) proven cost savings and patient care management tools should reduce prescription drug costs for health plan sponsors and consumers by an average of 20 percent, or more than $1 trillion, according to a new study by Visante commissioned by the Pharmaceutical Care Management Association (PCMA).
“PBMs are providing superior value to the health care system by generating meaningful savings across health care marketplaces that are flowing directly to consumers and providing care management support to patients to improve clinical outcomes,” said PCMA President & CEO JC Scott. “As this analysis indicates, with even greater use of PBM tools, we can achieve more market-based savings to further reduce drug costs for every patient.”
PBMs are the advocates for 266 million consumers in the fight to keep prescription drugs accessible and affordable. Using advanced tools to manage pharmacy benefits, such as negotiating price concessions from drug manufacturers, improving patient adherence to prescribed medications, encouraging the use of generic drugs, managing high-cost specialty medications, and offering more affordable pharmacy channels, PBMs have achieved an overall stable drug trend for prescription drug costs.
Key Findings in the Visante report include:
From 2020-2029, the current use of PBM tools in the marketplace will save plan sponsors and consumers more than $1 trillion:
- Commercial plan sponsors and members will save more than $512 billion;
- Medicare Part D and beneficiaries more than $445 billion; and
- Managed Medicaid plans more than $46 billion.
Cost-savings could shrink dramatically by government policies mandating coverage of brand-name drugs, requiring increased pharmacy reimbursement levels and limiting the use of mail-service pharmacies.