Merritt: 'Part D Plans Delivering Broad Access, Deep Savings for

Seniors & Disabled, While Reining In Overall Program Costs'



    PCMA Outlines Additional Policy Options for Improving Medicare Part D



    WASHINGTON, July 24 /EMWNews/ -- Testifying today before

the House Oversight and Government Reform Committee, Pharmaceutical Care

Management Association (PCMA) President and CEO Mark Merritt reported how

Medicare prescription drug plans (PDPs) and the pharmacy benefit managers

(PBMs) who administer them are generating broad access, driving deep

discounts on prescriptions for America's seniors and disabled beneficiaries

in Part D, and reining in overall program costs. In addition, Mr. Merritt

offered the Committee additional policy options for improving Medicare Part

D.



    "Working within the competitive Part D framework, PBMs offer Medicare

and its beneficiaries value by using proven tools and strategies that both

rein in drug spending and provide a high-quality prescription drug

benefit," said Mr. Merritt. "These tools -- pioneered by PBMs -- include

increasing generic utilization, improving formulary compliance rates, and

encouraging the use of lower-cost delivery channels, such as the

mail-service pharmacy option."



    As part of his testimony, Mr. Merritt urged policymakers to consider

other options to increase savings and access for Medicare Part D

beneficiaries, including:



    -- Establishing a clear regulatory pathway for biogenerics;



    -- Building upon the groundbreaking new e-prescribing incentives that

were just enacted as part of the "Medicare Improvements for Patients and

Providers Act"; and



    -- Taking a closer look at the six classes of clinical concern and the

associated cost implications on drugs used by dual eligibles. This policy

does not improve access but does make it difficult for PBMs to negotiate

rebates for drugs in those classes which can account for more than 40

percent of dual-related spending.



    In Part D, PBMs and plan sponsors have reduced overall program costs by

30 percent below government projections, offered beneficiaries

lower-than-expected premiums, and generated high levels of generic

utilization, while providing broad choice of drugs and access to over

60,000 pharmacies. In addition, overall savings of PDPs in Part D are also

comparable to levels achieved by PBMs in the Federal Employees Health

Benefits Program (FEHBP), according to analysis conducted by

PricewaterhouseCoopers (PwC).



    PCMA is the national association representing America's pharmacy

benefit managers (PBMs), which administer prescription drug plans for more

than 210 million Americans with health coverage provided through Fortune

500 employers, health insurance plans, labor unions, and Medicare Part D.