Suggesting ways to reduce prescription drug costs plus overall marketplace guidance, the Pharmaceutical Care Management Association (PCMA) recently wrote to Health and Human Services Secretary Tom Price, detailing potential pricing and savings allocation improvements.
Underscored by pharmacy benefit managers’ (PBM) desire to simplify consumer decisions, the communication served as a springboard for clarity. Rather than assuming that overall price reduction is the sole or primary goal, PCMA emphasized that such features as rebates and their causal relationship to enrollee premium prices and cost-sharing serve “to redistribute existing savings [and] not reduce overall costs,” officials said.
“In order to understand which policy solutions will reduce prescription drug costs, policymakers must first understand how drug pricing works and how PBMs help reduce costs for payers and patients,” PCMA President and CEO Mark Merritt said.
PCMA itemized information that it believes can best inform the system, including the facts that manufacturers set prices with no correlation to future hikes or rebates; that PBMs cooperate on discounts to achieve affordability; and that cost reduction depends on healthy competition.
Additionally, the letter stated that PBMs negotiate openly with paying parties; that PBMs’ role in rebates may result in higher beneficiary premiums and even taxpayer costs in Medicare Part D; and, finally, that PBMs advocate alternative options apart from rebates to keep costs down.
PCMA also made concrete recommendations in its missive to Price, suggesting approximately 10 economical and strategic solutions for the department’s consideration.