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New NCPA Study: Medicaid Pharmacy Modernization Could Save States Billions Without Limiting Access
Date:5/3/2011

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  • Increasing utilization of generic drugs;
  • Negotiating competitive dispensing fees;
  • Improving drug utilization controls; and
  • Negotiating discounts and reimbursements with drugmakers similar to commercial sector.

  • Recent polling finds voters would rather modernize Medicaid pharmacy than cut benefits for patients or payments to doctors and hospitals. In addition to Governor Perry, Governors Chris Christie (R-NJ) and Andrew Cuomo (D-NY) have already proposed such changes to reduce prescription drug spending in their own states.

    Many state Medicaid programs pay too much for prescription drugs because they use an archaic, fee-for-service approach in which state officials set payment rates and are therefore constantly lobbied to inflate them by special interests like pharmacists.  To avoid this trap, most non-Medicaid drug benefits programs – like those offered by Medicare, employers and unions – rely upon independent, third party pharmacy benefit experts to negotiate competitive rates with pharmacies. These programs also reduce costs by employing cutting-edge, market-proven strategies to increase the use of generics.

    PCMA represents the nation's pharmacy benefit managers (PBMs), which improve affordability and

    quality of care through the use of electronic prescribing (e-prescribing), generic alternatives, mail-service pharmacies, and other innovative tools for 210-plus million Americans.

    Follow PCMA on Twitter


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    SOURCE Pharmaceutical Care Management Association
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