Response to XIL Consulting’s “Payers and PBMs Profit from Obscure Pharmacy Fees, While Seniors See No Relief in Prescription Costs”
A recent blog (“Payers and PBMs Profit from Obscure Pharmacy Fees, While Seniors See No Relief in Prescription Costs”) suggests performance-based price concessions are retained by PBMs, restrict the growth of independent pharmacies, and inflate Medicare Part D enrollee’s out-of-pocket costs—unfounded suggestions that evidence does not support.[1] Performance-based Pharmacy Reimbursement Saves Taxpayer Dollars and Helps Lower...
Categories: Uncategorized
Just the Facts: Pharmacy Direct and Indirect Remuneration Increases Value and Improves Quality
During the Energy and Commerce Health Subcommittee hearing on “The Fiscal Year 2021 HHS Budget and Oversight of the Coronavirus Outbreak” several inaccurate remarks were made on pharmacy direct and indirect remuneration (DIR). What is Pharmacy DIR? Pharmacy benefit managers (PBMs) and Part D plan sponsors use pharmacy DIR to create high-quality, value-based pharmacy networks,...
Categories: Press Releases
How Pharmacy Networks Could Save Medicare, Medicaid, and Commercial Payers $115 Billion
Over the past twenty years, pharmacy networks have generated significant savings. Today, there is even greater potential savings available through preferred and limited pharmacy network options: Read the Visante pharmacy networks study. Major findings include: Greater use of preferred and limited pharmacy networks generates savings. Greater use of preferred and limited pharmacy networks could save...
Categories: Employers, Unions, & Insurers, Medicaid, Medicare Part D, Pharmacy Networks, Research, Specialty Pharmacy Networks
Survey: 85% of Part D Seniors in Preferred Pharmacy Plans are Satisfied With Costs, Pharmacy Choices
(Washington, DC)— Medicare Part D seniors in plans with preferred pharmacy networks are overwhelmingly satisfied, citing lower costs, convenient access to pharmacies and other benefits, according to a new survey from Hart Research Associates released today by the Pharmaceutical Care Management Association (PCMA). More than 40% of Part D seniors (9.5 million) are currently...
Categories: Drug Cost Management, Medicare Part D, Pharmacy Networks, Press Releases
Research: Medicaid Pharmacy Savings Opportunities: National and State-Specific Estimates
Executive Summary This study explores how more efficient pharmacy benefits management—apart from drug manufacturer rebates—could save Medicaid an additional $74.4 billion over the next decade. These savings opportunities are compelling as the federal government and states strive to protect benefits and prepare for the Medicaid expansion authorized by the Affordable Care Act starting in...
Categories: Drug Abuse Prevention, Drug Cost Management, Formulary Design, Medicaid, Press Releases
New Research: How Pharmacy Networks Could Save Medicare, Medicaid, and Commercial Payers $115 Billion
Over the past twenty years, pharmacy networks have generated significant savings. Today, there is even greater potential savings available through preferred and limited pharmacy network options: Read the Visante pharmacy networks study. Major findings include: Greater use of preferred and limited pharmacy networks generates savings. Greater use of preferred and limited pharmacy networks could save...
Categories: Drug Cost Management, Medicaid, Medicare Part D, Pharmacy Networks, Pharmacy Reimbursement & Contracting, Press Releases, Value & Outcomes-Based Contracting