April 8, 2019

(Washington, D.C.) — Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott issued the following statement on the association’s public comments on the Health and Human Services Office of Inspector General’s proposed rule revising the safe harbors around prescription drug rebate negotiations in Medicare and Medicaid managed care.

“We understand that the status quo on drug pricing is not sustainable, and that we all have a role to play in finding solutions. There is a constructive conversation to be had on how best to balance the use of PBM-negotiated prescription drug savings between premium reduction and lower out-of-pocket costs, and we stand ready to work with policymakers and the Administration to reduce list prices and costs to consumers. However, as it currently stands, the proposed rule does not achieve those objectives.

As drafted, the proposed rule risks significantly increasing premiums for all Part D beneficiaries, raising taxpayer costs for the program, and destabilizing Medicare Part D.

To help mitigate those risks, if the proposed rule moves forward, it should be modified to ensure that PBMs can effectively negotiate lower drug prices for Medicare beneficiaries and utilize existing infrastructure to efficiently administer any changes to how savings are utilized. PBMs are the entities in the supply chain best positioned to help accomplish the Administration’s goals on Medicare rebate reform.

Drug manufacturers alone have the power to set prices. PBMs provide an essential, and indeed the only, check against drugmakers’ pricing strategies. In negotiating lower drug costs on behalf of 266 million consumers, PBMs have a successful track record of achieving an overall stable cost trend for prescription drugs in private insurance and public programs, as well as affordable Medicare Part D premiums.”

Click here to read PCMA’s public comments on the proposed rule.