HHS "has no idea what the real-world impact" would be of a proposal to restrict pharmacy benefit managers' ability to negotiate drug rebates, says Pharmaceutical Care Management Association President and CEO JC Scott. He says PCMA will focus on "educating people on the impact and the risk to seniors, government cost, and the risk to the [Medicare] Part D program."
An HHS proposal to restrict how pharmacy benefit managers use manufacturer rebates might reduce out-of-pocket costs for some Medicare and Medicaid beneficiaries, but it could also raise premiums across the board, according an analysis by Milliman. "I am sympathetic there is an urgency to addressing high drug costs, but this particular proposal has not been thought through," said Pharmaceutical Care Management Association President and CEO JC Scott.
A Health Care Cost Institute report found health care spending per person climbed 4.2% year over year in 2017, while total health care utilization increased by 0.2%. The spending growth was largely driven by rising health care prices, which increased 17.1% between 2013 and 2017.
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