PCMA Unveils Three-Part Policy Platform to Reduce Prescription Drug Costs

(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) today is announcing a new three-part policy platform, supported by America’s pharmacy benefit managers, PBMs, aimed at reducing prescription drug costs by updating Medicare Part D, enhancing competition, and building toward a more value-driven health care system for patients.

“PCMA’s multi-faceted policy platform provides specific policy actions to increase the affordability of prescription drugs for every patient, and it establishes PBMs’ vision for a health care system that provides greater value for every American,” said PCMA President and CEO JC Scott. “We look forward to working with Congress and the Administration to implement real solutions to achieve this shared goal.”

Please visit PCMA’s website to view the three-part policy platform, “The Critical Path Forward: Rx Policies to Reduce Costs, Improve Access.

A key component of PCMA’s new set of policies is the modernization of Medicare Part D. In the context of an updated Part D program that includes enhanced manufacturer responsibility throughout the benefit phases and additional tools for managing costs. PCMA supports an annual limit on out-of-pocket spending in the Medicare Part D prescription drug benefit. Capping annual out-of-pocket costs provides better financial protection for beneficiaries with high drug costs.

Critically important are policies to eliminate manufacturers’ abilities to use patent thickets, daisy-chained exclusivity extensions, evergreening, and other techniques to avoid fair competition from generic and biosimilar drugs. PCMA proposes a broad range of policies to stem these practices. Also, the package of policy proposals includes the permanent repeal of the rebate rule. Allowing the rebate rule to take effect will significantly increase premiums in Part D and substantially add to taxpayer costs.

In addition, greater adoption of value-based purchasing and accelerating patient-focused pharmacy care can further improve health outcomes. Providing Part D drug plans with access to Medicare Parts A and B claims data, establishing safe harbors for value-based contracting, and allowing Part D and state Medicaid plans greater flexibility to adopt private-sector formulary management techniques would make value-based care arrangements more effective for patients.

# # #

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.