Navigation Links
PCMA: New Report Shows Drugstore Lobby Agenda Raises Rx Costs for Small Businesses, Government Programs
Date:3/20/2013

WASHINGTON, March 20, 2013 /PRNewswire-USNewswire/ -- Federal and state policymakers should avoid enacting laws that undermine payers' ability to use mail-service pharmacies, preferred pharmacy networks, and other innovative pharmacy benefit management (PBM) tools, the National Center for Policy Analysis (NCPA) asserts in a new report, "Unnecessary Regulations that Increase Prescription Drug Costs."

"This report shows policymakers that appeasing the drugstore lobby means higher prescription drug costs for small businesses, consumers, and government programs," said Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt .

Click here to read the NCPA report which highlights a number of regulations and laws that could increase prescription drug costs, including:

Barriers to Competition: State Boards of Pharmacy Conflict of Interest
Background: The report highlights how some states are seeking to transfer regulatory authority of drug plans from the state's insurance commissioner to the state's Board of Pharmacy.

NCPA: "Because state pharmacy boards are controlled by pharmacists, giving them authority over drug plans creates conflicts of interest that could undermine drug plans' ability to negotiate lower prices with pharmacy networks."

Barriers to Lower Cost Mail-Service Pharmacies
Background: Employers and payers use a variety of incentives to encourage patients to use efficient mail-service pharmacies to address chronic illnesses, such as diabetes.  Mail-service pharmacies will save Medicare seniors, employers, unions, government employee plans, consumers, and other commercial-sector payers $46.6 billion in prescription drug costs over the next ten years.

NCPA: "Unfortunately, some states are enacting laws that interfere with the ability of drug plans to reward enrollees that use the plan's mail order option by barring drug plans from offering lower prices for mail-order dispensing.  This unnecessarily raises costs for consumers, insurers and employers. Obviously, these laws mostly aim to benefit local community pharmacies rather than consumers."

Barriers to Competitive Pharmacy Networks
Background: A new study finds that the extraordinary number of pharmacies in the United States offers an opportunity to save $115 billion over the next decade through the greater use of preferred and limited pharmacy networks.  However, some states have in place so-called "any willing pharmacy" laws and regulations that force plans to contract with pharmacies that don't meet their quality standards or geographic access needs.  

NCPA: "These any-willing-pharmacy laws are costly to taxpayers, employers and patients alike. The Federal Trade Commission notes that these laws reduce the drug plans' bargaining power, leading to higher drug prices and higher premiums for consumers."

Barriers to Efforts to Combat Fraud
Background: Health care fraud is a problem that increases overall health costs and is especially burdensome in Medicare and Medicaid. Billions of claims are submitted to millions of providers, making fraudulent claims easy to disguise. PBMs and companies processing electronic payments are effective at discovering irregularities that lead to fraud.

NCPA: "Regulations requiring Medicare drug plan administrators to pay claims within 14 days make it difficult to detect fraud before a claim has been paid. At the very least, drug plans need the authority to delay paying questionable claims to providers suspected of fraud. Plans also need greater authority to exclude or suspend suspected fraudulent providers from networks and conduct routine audits of participating pharmacies.

"Congress and state legislatures should avoid well-meaning, but ill-conceived, regulations intended to protect consumers, which often have the opposite result. A better way to ensure desirable outcomes is to promote a competitive environment free of market distortions that favor one party over another."

Barriers to Lower Cost Dispensing Fees
Background: Dispensing fees paid to drugstores and pharmacists that are mandated and set by states are much higher than in commercial drugs plans. The average Medicaid dispensing fees range from $1.75 in New Hampshire to $10.64 in Alabama, averaging about $4.81 per prescription across the country.  By contrast, privately managed Medicare Part D plans negotiate fees with pharmacies of about $2 per prescription.

NCPA: "Dispensing fees in state-managed, conventional Medicaid plans are set by the state. State officials and state legislatures often yield to political pressure and set dispensing fees that are much higher than what private drugs plans could negotiate if allowed to do so. When the fees are set too high, taxpayers pay pharmacies more than they would in a competitive market."

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 215 million Americans.

Follow PCMA on Twitter


'/>"/>
SOURCE Pharmaceutical Care Management Association
Copyright©2012 PR Newswire.
All rights reserved

Related medicine technology :

1. PCMA: New Report Shows Anti-PBM Laws Could Raise Health Care Costs for Oklahoma Businesses, Consumers, Government Programs
2. PCMA: The Drugstore Lobby (Again) Looks to Avoid Fraud and Abuse Detection
3. PCMA: 88 U.S. Representatives Urge USPS to Preserve Six Day Delivery of Mail-Service Pharmacy
4. PCMA: Part D Plans and PBMs Continue to Deliver Savings in Medicare
5. PCMA: New Study Finds Generic Medications Saved $1 Trillion Over the Last Decade
6. PQA and CECity Launch Joint Venture to Deliver First National Pharmacy Quality Measurement, Benchmarking and Reporting Platform for Pharmacies and Health Plans
7. Star Scientific and Rock Creek Pharmaceuticals Report on the Beneficial Nutritional Effects of Anatabine in an Animal Model of Ulcerative Colitis
8. Mast Therapeutics Reports Fourth Quarter And Full Year 2012 Financial Results
9. Inovio Pharmaceuticals Reports 2012 Fourth Quarter and Year End Financial Results
10. BioDelivery Sciences Provides Business Review and Update in Conjunction with Filing of its 2012 Annual Report
11. Patient Safety Technologies Reports Fourth Quarter And Fiscal 2012 Results
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/23/2016)... , June 23, 2016  MedSource announced today ... its e-clinical software solution of choice.  This latest ... possible value to their clients by offering a ... preferred relationship establishes nowEDC as the EDC platform ... MedSource,s full-service clients.  "nowEDC has long been a ...
(Date:6/23/2016)... Any dentist who has made an implant supported ... Many of them do not even offer this as a ... laboratory costs involved. And those who ARE able to offer ... high cost that the majority of today,s patients would not ... Zadeh , founder of Dental Evolutions Inc. and inventor of ...
(Date:6/23/2016)... startling report released today, National Safety Council research shows ... plan to eliminate prescription opioid overdoses. Prescription Nation ... the worst drug crisis in recorded U.S. history, assigned a "Making ... , New Mexico , Tennessee ... states, three – Michigan , Missouri ...
Breaking Medicine Technology:
(Date:6/27/2016)... Lafayette, California (PRWEB) , ... ... ... a pioneer in the patient payment industry today announced its strategic partnership ... and health system workflows. , The two companies’ proven, proprietary technology combine ...
(Date:6/26/2016)... ... June 27, 2016 , ... Quality metrics are proliferating in cancer ... they remain in the eye of the beholder, according to experts who offered insights ... American Journal of Managed Care. For the full issue, click here . , ...
(Date:6/26/2016)... North Carolina (PRWEB) , ... June 26, 2016 , ... ... release of a new product that was developed to enhance the health of felines. ... for centuries. , The two main herbs in the PawPaws Cat Kidney Support ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, at the Hynes ... important health care topics including advance care planning, healthcare costs and patient and ...
(Date:6/25/2016)... ... June 25, 2016 , ... "With 30 hand-drawn hand gesture animations, ... Christina Austin - CEO of Pixel Film Studios. , ProHand Cartoon’s package transforms ... Final Cut Pro X . Simply select a ProHand generator and drag it above ...
Breaking Medicine News(10 mins):