Innovative PBM tools reduce prescription drug costs for consumers | PCMA offers to work with FDA chief Scott Gottlieb to address the opioid crisis | FDA commissioner vows action to boost generic-drug development
Pharmacy benefit managers offer patient-friendly cost-savings options such as home delivery of drugs for chronic conditions, writes Ed Pezalla, a scholar-in-residence at the Duke-Margolis Center for Health Policy. "Through their expertise and market scale, PBMs are able to reduce drug costs by negotiating rebates and discounts from big drug companies and drugstores. It would be too expensive and complicated for employers, or other payers, to match PBMs' ability to reduce drug costs, while providing access," he writes.
Makers of brand-name drugs "game the system and game the rules" of a patient safety program to prevent generic-drug makers from obtaining adequate samples for equivalence studies, says FDA Commissioner Scott Gottlieb, who has vowed action to curb the practice.
Cincinnati and South Carolina have joined other cities and states in taking legal action against pharmaceutical firms and distributors for allegedly fueling the opioid addiction crisis. Cincinnati filed a public nuisance lawsuit against McKesson, Cardinal Health and other major drug distributors for allegedly allowing large amounts of oxycodone and hydrocodone to flood the black market, while South Carolina sued opioid maker Purdue Pharma for deceptive marketing practices, saying the company inflates opioids' benefits while downplaying the drugs' addictive properties and the quality of newer abuse-deterrent drugs.
Express Scripts will limit new prescriptions for opioid drugs to seven days' worth, require that first-time prescriptions be for short-acting drugs, set dosage limits and monitor prescriptions for patterns of potential doctor-shopping. Patients with cancer and those in hospice or palliative care are exempt.
Diplomat Pharmacy's quarterly earnings report shows declining direct and indirect remuneration fees as a share of gross profit, and the specialty pharmacy "is signaling its intention to play a more significant role in the pharmacy benefit management (PBM) business," writes Pembroke Consulting President Adam Fein.
PCMA is the national association representing America's pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 266 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D. PCMA is dedicated to enhancing the proven tools and techniques pioneered by PBMs that generate savings and access for consumers and payors.
Contact PCMA Charles Cote
Vice President, Strategic Communications