Pharmacy Services Administrative Organizations (PSAOs) and their Little-Known Connections to Independent Pharmacies

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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...

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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,...

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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...

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PCMA Launches New Medicare Ad Campaign: ‘We Love Our Preferred Pharmacy Plan: Don’t Let Special Interests Take It Away’

The Pharmaceutical Care Management Association (PCMA) today released a new ad campaign – “We Love our Preferred Pharmacy Plan” – highlighting the popularity and convenience of lower cost preferred pharmacy plans in Medicare. “Lower cost preferred pharmacy plans have become the very foundation of Medicare Part D,” said PCMA President and CEO Mark Merritt. “It...

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Drugstore Lobby “Any Willing Pharmacy” Bill Would Increase Costs by $21 Billion

  (Washington, D.C.)— “Any Willing Pharmacy” legislation (H.R. 793) in Medicare Part D, backed by the drugstore lobby, would undermine the availability of lower cost, preferred pharmacies and increase Medicare spending by $21 billion over the next 10 years, according to research from The Moran Company examining the same bill introduced last year. Seniors enrolled...

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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...

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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...

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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...

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PCMA: Governor Cuomo’s Call to Amend Anti-Mail-Service Pharmacy Law Protects Employers and Consumers

  (Washington, DC)— Addressing concerns over anti-mail-service pharmacy legislation, New York Governor Andrew Cuomo announced today that both Houses of the legislature have agreed to amend NY AB 5502-B, which prevents employers from offering discounts to encourage the use of the lower cost mail-service pharmacy option. “Employers, taxpayers, and consumers appreciate Governor Cuomo’s admonition to...

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