January 17, 2012
(Washington, DC) — The Pharmaceutical Care Management Association (PCMA) today launched a new ad campaign – “That’s What PBMs Do” – that highlights the core value proposition of pharmacy benefit managers (PBMs). The ad campaign focuses on key themes including:
- PBMs reduce pharmacy costs for employers, unions, and consumers
- PBMs play a key role in the Medicare Part D success story
- PBM mail-service pharmacy improves safety, savings, and convenience
- PBMs help patients adhere to their medication regimens.
“This ad campaign will educate policymakers and opinion leaders about the important savings and safety benefits PBMs provide to more than 216 million Americans,” said PCMA President and CEO Mark Merritt.
In addition to the ad campaign, a new PCMA video highlights the innovative tools and programs PBMs use to make prescription medications safer and more affordable for more than 216 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.
PBMs will save consumers and payers almost $2 trillion in prescription drug costs – a 35 percent savings – over the next decade, according to new research from Visante. The research also found that another $550 billion could be saved if payers used the full array of savings-tools that PBMs offer.
PBMs improve safety and savings in several ways:
- Negotiating Discounts from Drugstores and Drug Manufacturers: Retail pharmacies provide discounts to be included in a plan’s pharmacy network. The more selective the network, the greater the discount, since each pharmacy will gain business. PBMs negotiate rebates from manufacturers of brand drugs that compete with therapeutically similar brands and generics. Manufacturers typically provide a rebate if their product is “preferred,” which means it is assigned a copay lower than competing products.
- Offering Home Delivery of Medicines: Mail-service and specialty pharmacy channels typically give plan sponsors deeper discounts than do retail pharmacies. These channels also help encourage the use of preferred products for additional savings.
- Encouraging Use of Generics and Less Expensive Brands: PBMs use several tools to encourage the use of generic drugs and preferred brands. These include: formularies and tiered cost sharing, prior authorization and step therapy protocols, generic incentives, consumer education, and physician outreach. As PBMs and plan sponsors strive for greater savings, drug mix becomes even more important.
- Using Cutting-Edge Tools to Improve Adherence: PBMs use Drug Utilization Review (DUR) to reduce waste such as polypharmacy and implement patient adherence programs to help patients stick to their prescription regimens. Both programs improve clinical outcomes and influence prescription volume and expenditures.
- Improving Quality and Safety: PBMs promote the use of technology like e-prescribing to improve quality and safety by preventing drug duplication and dangerous drug-to-drug interactions.