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PCMA: Study Credits PBM Tools with Reducing Prescription Drug Spending Growth
Date:7/28/2011

WASHINGTON, July 28, 2011 /PRNewswire-USNewswire/ -- Prescription drug spending growth slowed from an estimated 5.3 percent in 2009 to 3.5 percent in 2010, according to new data released today by the Centers for Medicare and Medicaid Services (CMS) and reported on in Health Affairs. Researchers credit the slowdown in spending growth to pharmacy benefit management tools like tiered copays shifting medication use toward lower cost generic drugs. Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt released the following statement today on the new data:

"This new research confirms that innovative PBM tools – including incentivizing the use of generic medications – lower costs for consumers and payers. Payers and policymakers alike should explore broader use of PBMs' cost-saving tools and reject policies that make it harder to reduce prescription drug costs.

"The cost explosion in Medicaid pharmacy – which unlike Part D and the commercial market rejects many PBM tools – is a stark reminder of the need to modernize pharmacy benefits.

"As Medicaid expands under the health care law, policymakers should explore the Part D model for consumer-friendly ways to reduce wasteful spending in Medicaid pharmacy. According to a recent report, states and the federal government could save $33 billion – without cutting benefits for patients or payments to doctors and hospitals – by bringing Medicaid pharmacy benefits into the 21st century."

Key data points from today's Health Affairs report include:

  • Prescription drug spending growth slowed from an estimated 5.3 percent in 2009 to 3.5 percent in 2010.
  • "This deceleration resulted from continued slow growth in the use of drugs and the ongoing change in the mix of drugs purchased," according to CMS.
  • The generic dispensing rate is projected to have increased to 69 percent in 2010, up from 66 percent in 2009.
  • "Through tiered copays and other mechanisms, health plans have continued to shift medication use toward less-costly generic drugs," according to CMS.

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 200-plus million Americans.

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SOURCE Pharmaceutical Care Management Association
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