September 1, 2021
(Washington, D.C.) — Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott issued the following statement on the “2021 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds:”
“The 2021 edition of the Medicare Trustees’ report highlights that negotiations between pharmacy benefit managers, PBMs, and drug manufacturers for price concessions and rebates, as well as an increasing generic utilization rate, are key factors toward lowering overall Medicare Part D spending. Once a drug manufacturer sets the list price for a medication, PBMs negotiate for rebates to lower the cost of the drug for patients and health plan sponsors.
“The Trustees’ report should serve as an impetus to Congress to repeal the previous Administration’s rebate rule, which would significantly raise spending in the Part D program and increase premiums, effectively undoing Part D’s fiscal progress and stability outlined in the Trustees’ report.
“Rebates are one form of direct and indirect remuneration, DIR, which is made up of PBM-negotiated price concessions from drug manufacturers and pharmacies. As stated in the report, the ability to negotiate lower costs from pharmacies and from manufacturers ‘has significantly slowed Part D spending growth.’
“PCMA looks forward to working with the Biden administration and Congress to lower prescription drug costs, and we encourage policymakers to examine a comprehensive set of policy reforms that would save taxpayers over $255 billion in drug costs.”
PCMA is the national association representing America’s pharmacy benefit managers (PBMs). PBMs administer prescription drug plans for more than 266 million Americans who have health insurance from a variety of sponsors including: commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.