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  • Issues
    • Affordable Future
    • Biosimilars
    • COVID-19
    • Pharmacy Direct and Indirect Remuneration (DIR)
    • Drug Pricing Issues
      • Insulin
    • Health Equity
    • Patient Care
    • PBMs and Pharmacies
      • Mail-Service Pharmacy
      • Specialty Pharmacies
      • The Independent Pharmacy Marketplace is Stable
    • PBM Tools
    • Rebates
    • Transparency
    • Value of PBMs
  • Newsroom
    • Press Releases
    • CEO’s Perspective
    • The Pharmacy Benefit Podcast
    • Research
      • Rx Research Corner Blog
    • Infographics
    • News Highlights
  • About PCMA
    • PCMA Members
    • PCMA Board of Directors
    • PCMA Affiliates
    • PCMA Team
    • PCMA Foundation
  • PCMA Events
    • PCMA Business Forum 2023
    • PCMA Sponsors
    • 2023 Events
    • Past Events
  • Member Login
  • Industry Relations Login
Search
    • PBM Audits Infographic (2023)
      February 17, 2023
      Infographic

      A PCMA infographic explaining the type of audits, value of audits, and examples of fraud, waste, and abuse.

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    • WI LRB 1933 Comment Letter (2023)
      February 10, 2023
      Comment Letter

      Comment Letter circulated to legislators addressing WI LRB 1993, a copay accumulator bill.

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    • MN HF 294 Comment Letter: Frozen Formulary (2023)
      January 31, 2023
      Comment Letter

      A comment letter on MN HF 294, a bill that would limit the ability to make formulary changes during a plan contract term such as setting prior notice requirement for notifying pharamices of formulary changes, and adds criteria for moving drugs to higher tier.

      View Document >

    • WV SB 267 Comment Letter: Gold Carding, Prior Authorization (2023)
      Comment Letter

      A comment letter addressing WV SB 267.  The comment letter addressess concerns with decreasing the prior authorization approval threshold for practitioners to be “gold carded”, and proposed changes to the require response time to a prior authorization request.

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    • Explainer: What Is a PBM Pharmacy Audit (2023)
      InfographicTalking Point

      Explains the types of pharmacy audits, and various reasoning for pharmacy audits being conducted.

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    • Pharmacy Audits Protect Consumers (2023)
      InfographicTalking Point

      An explainer on the value of pharmacy audits.

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    • Explaining White Bagging (2023)
      InfographicTalking Point

      High level overview document explaining what white bagging is.

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    • Benefits of White Bagging (2023)
      InfographicOne-Pager

      Includes messaging of the benefits of White Bagging

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    • OK BoP Proposed Rule–Chapter 15 Comment Letter (2023)
      January 27, 2023
      Comment Letter

      A comment letter PCMA submitted to the OK Board of Pharmacy regarding the Boards Proposed Rule, specifically the Chapter 15 Draft Rules on the physical requirements for certain prescription drug packaging and shipping methods as conducted by non-resident pharmacies.

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    • NJ S. 3480/S. 2824 Comment Letter (2023)
      January 26, 2023
      Comment Letter

      This comment letter adddresses S. 3480/S. 2824, which among other things, limits the use of step therapy in the small group market.

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    • Pharmacy Audits White Paper (2023)
      January 25, 2023
      Research and Analysis

      New white paper reviews the value of pharmacy audits conducted and provides analysis on effectiveness of identifying for fraud, waste, and abuse.

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    • White Paper: The Return on Investment on PBM Services (2023)
      January 23, 2023
      Research and Analysis

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    • White Paper: PBMs Generating Savings for Plan Sponsors and Consumers (2023)
      Research and Analysis

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    • White Paper: Increased Costs Associated with State Legislation Impacting PBM Tools (2023)
      Research and Analysis

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    • PBMs Save Employers and Patients 100B Per Year on Drug Costs Infographic (2021)
      December 1, 2022
      Infographic

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    • PBM Tools Save in Seven Ways Infographic (2020)
      Infographic

      View Document >

    • PBM Industry Principles (2021)
      One-Pager

      View Document >

    • One Pager, Study Confrims Value of PBM Tools, Private Sector Negotiation (2021)
      One-Pager

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    • PCMA’s The Critical Path Forward Will Save Taxpayers $255.5 Billion Over 10 Years One Pager (2021)
      One-Pager

      This one pager highlights, The Critical Path Forward, PCMA’s three-part approach to lower prescription drug costs and make high-quality pharmaceutical care even more accessible. By updating Medicare Part D, enhancing competition to lower drug costs, and building a more value-driven health care system, our approach would save taxpayers $255.5 billion over a decade.

      View Document >

    • CO DOI Insulin Copay Regulation Amendments Comment Letter (2022)
      November 30, 2022
      Comment Letter

      PCMA submitted the attached comments on the DOI’s proposed amendments to Colorado’s insulin copay regulations.  The proposed amendments were meant to implement the changes from HB 21-1307

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    • P&T Committees One Pager (2018)
      November 29, 2022
      One-Pager

      One Pager outlining the importance and value of state P&T Committees.

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    • Requiring Cost-Based, Cost-Plus Pharmacy Reimbursement Raises Costs and Undermines Value (2021)
      One-Pager

      One pager addressing implications of NADAC + Reimbursment mandates.

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    • Dispensing Fees Infographic (2021)
      Infographic

      Infographic addressing cost of NADAC + Dispensing Fees.

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    • A 21st Century Pharmacy–Mail Service Pharmacies Infographic (2021)
      Infographic

      View Document >

    • Value of MAC Lists in Keeping Generics Affordable Infographic (2021)
      Infographic

      View Document >

    • PBMS Are Innovating to Increase Affordable Access to Insulin
      One-Pager

      View Document >

    • Five Facts on Insulin (2021)
      One-Pager

      View Document >

    • Milliman Research Report: Cost of Potential Frozen Formulary Legislation (2021)
      November 23, 2022
      Research and Analysis

      A Research report conducted by Milliman assess the financial impact of potential “frozen formulary” legislation on fully insured commercial health insurance market payer costs from 2021-2025. The research finds that it would cost the commercial market between $4.3 billion to 7.1 billion.  Read the full report and analysis.

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    • Frozen Formulary Talking Points (2021)
      Talking Point

      Talking points that explain and address ‘Frozen Formularies’

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    • Explaining Prescription Drug Formularies (2021)
      One-Pager

      An explainer of prescription drug formularies and the array of PBM formulary management tools.

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    • PBMs as a Fiduciary One Pager (2021)
      One-Pager

      A one pager explaining the negative impact with state proposals to impose a fiduciary mandate on PBMs

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    • Illinois Fiduciary Mandate Fiscal Impact (2021)
      Fiscal Note

      Cost impact of proposed PBM fiduciary mandate provision in Illinois.

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    • Washington Mandated Pharmacy Reimbursement Rate Fiscal Impact
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost Washington Over $3.2 Billion Dollars in Increased Spending

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    • Utah Mandated Pharmacy Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost Utah Over $1.7 Billion Dollars in Increased Spending

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    • South Dakota Mandated Pharmacy Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      New South Dakota Legislation mandating NADAC reimbursement plus dispensing fee Could Cost Over $419 Million Dollars in Increased Spending

      View Document >

    • Pennsylvania Mandated Pharmacy Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost Pennsylvania Over $7.1 Billion Dollars in Increased Spending

      View Document >

    • North Dakota Mandated Pharmacy Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost North Dakota Over $382 Million Dollars in Increased Spending

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    • Nevada Mandated Prescription Drug Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost Nevada Over $1.4 Billion Dollars in Increased Spending

      View Document >

    • Nebraska Mandated Prescription Drug Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost Nebraska Over $1.1 Billion Dollars in Increased Spending

      View Document >

    • Kentucky Mandated Prescription Drug Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost Kentucky Over $2.7 Billion Dollars in Increased Spending

      View Document >

    • Kansas Mandated Prescription Drug Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost Kansas Over $1.8 Billion Dollars in Increased Spending

      View Document >

    • Illinois Mandated Prescription Drug Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost Illinois Over $6.2 Billion Dollars in Increased Spending

      View Document >

    • Alaska Mandated Prescription Drug Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Mandating a Prescription Drug Reimbursement Rate Could Cost Alaska Over $226 Million Dollars in Increased Spending

      View Document >

    • Alabama Mandated Prescription Drug Reimbursement Rate Fiscal Impact (2021)
      Fiscal Note

      Fiscal Note of AL legislation mandating a $10.50 dispensing fee would cost state over $3.4 Billion dollars in increased spending.

      View Document >

    • Supreme Court and ERISA One Pager (2021)
      One-Pager

      View Document >

    • Rutledge V PCMA Talking Points (2020)
      Talking Point

      View Document >

    • PCMA V Scotus Rule One Pager (2020)
      One-Pager

      View Document >

    • Real Time Benefit Tools Talking Points (2022)
      Talking Point

      View Document >

    • Audits Save Money and Protect Consumers One-Pager (2022)
      November 14, 2022
      One-Pager

      View Document >

    • PBM Facts (2022)
      One-PagerTalking Point

      One pager addressing common PBM arguments and the PBM “facts” vs “misconceptions”

      View Document >

    • MS HB 733 & HB 780 Comment Letter (2022)
      October 28, 2022
      Comment Letter

      Opposition letter to HB 733, which seeks mandate NADAC reimbursement, limit ability for preferred networks, as well as provisions on pharmacy audits.

      View Document >

    • MN HF 3854 Comment Letter (2022)
      Comment Letter

      PCMA concerns with HF 3854, a prohibition of step therapy for antiretroviral drugs

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    • MN HF 3611 Testimony (2022)
      Comment Letter

      Testimony before the House Commerce Committee addressing Copay Accumulators

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    • MN HF 3280 Testimony (2022)
      Comment Letter

      PCMA Testimony addressing HF 3280, a white bagging bill

      View Document >

    • MN HF 58 Testimony (2022)
      Comment Letter

      Testimony on bill addressing frozen formulary

      View Document >