June 23, 2021
Welcome to the Pharmacy Benefit Brief. This brief is your monthly snapshot of news from America’s prescription drug supply chain including pharmacy benefit managers, independent pharmacies, and drug manufacturers.
Medicaid Pharmacy Benefits: To Be or Not to Be…
State Medicaid programs are a crucial safety net for vulnerable populations. Medicaid programs have two broad options available for purchasing prescription drugs: the state agency can do it themselves, or they can use managed care organizations (MCOs) and PBMs. A new study on Medicaid prescription drug cost data shows that there is a difference between the options. The study finds that Illinois’ Medicaid MCO/PBM model paid far less for Hepatitis C drugs than did the Medicaid program in Michigan that did not use an MCO and PBM. In other words, when the state ran the show instead of PBMs, prescription drugs were more expensive.
Whether your state is grappling with this type of Medicaid decision or you just want to learn more about pharmacy benefits and how PBMs lower costs, take a look at the study: “The Myth that the State can do Better: Medicaid Drug Prices and Managed Care Organizations.”
The study’s author, Ike Bannon from the Manhattan Institute, wrote an op-ed on the study in Forbes:
“Pharmacy benefit managers sometimes get accused of being little more than middlemen, but that facile perspective ignores the fact that they can create real value for their clients by using their experience and combined market power to obtain bigger discounts than the government could obtain on its own. …the pharmaceutical market is a constantly changing landscape that requires continuous attention and deep industry knowledge, which is something that PBMs have in abundance.”
Did you Know?
When it comes to dispensing prescription drugs, “accreditation” means something. Pharmacy accreditation encourages improvement and higher quality pharmacy care by consistently evaluating practices so that they meet current best practices within the industry.
Forty-eight states, the District of Columbia, and six federal agencies require Utilization Review Accreditation Commission, or URAC, accreditation in state and federal statutes, regulations, agency publications, and requests for proposals or contract language. URAC is internationally recognized as an accrediting organization both in the United States and in four countries outside the United States.
Pharmacies that are accredited implement ongoing management of quality procedures, including establishing a quality committee and maintaining educational support and training to assist with adherence to standards.
The Latest in Rx News
A new analysis shows the average annual salary of retail and long-term care pharmacies.
The Drug Channels blog published an article this month analyzing the Bureau of Labor Statistics (BLS) employment and salary data for 2020. The BLS data says that “For 2020, there were 182,310 pharmacists employed at retail outpatient settings: chain drugstores, independent pharmacies, supermarkets, mass merchants, and mail pharmacies” and further that pharmacists in retail, independent, and long-term care pharmacies make an average annual salary of $122,840.