February 7, 2012 -- The Pharmaceutical Care Management Association (PCMA) launched a new ad campaign in Oregon that highlights the core value proposition of pharmacy benefit managers (PBMs). The ad campaign - "That's What PBMs Do" - focuses on key themes including:
PBMs lower costs for employers, unions, and consumers
PBM mail-service pharmacies improve safety, savings, and convenience
PBMs help patients make informed prescription drug decisions and improve adherence.
"This ad campaign will educate key Oregon decision makers about the important savings and safety benefits PBMs provide to employers, unions, and consumers," said PCMA President and CEO Mark Merritt.
PBMs will save Oregon consumers and payers $20 billion in prescription drug costs - a 35 percent savings - over the next decade. Nationally, PBMs will save consumers and payers, including Medicare Part D, almost $2 trillion in prescription drug costs over the next decade, according to new research from Visante.
In addition to the ad campaign, a new PCMA video highlights the innovative tools and programs PBMs use to make prescription medications safer and more affordable for more than 215 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D.
PBMs improve safety and savings in several ways:
Negotiating Discounts from Drugstores and Drug Manufacturers: Retail pharmacies provide discounts to be included in a plan's pharmacy network. The more selective the network, the greater the discount, since each pharmacy will gain business. PBMs negotiate rebates from manufacturers of brand drugs that compete with therapeutically similar brands and generics. Manufacturers typically provide a rebate if their product is "preferred," which means it is assigned a copay lower than competing products.
Offering Home Delivery of Medicines: Mail-service and specialty pharmacy channels typically give plan sponsors deeper discounts than do retail pharmacies. These channels also help encourage the use of preferred products for additional savings.
Encouraging Use of Generics and Less Expensive Brands: PBMs use several tools to encourage the use of generic drugs and preferred brands. These include: formularies and tiered cost sharing, prior authorization and step therapy protocols, generic incentives, consumer education, and physician outreach. As PBMs and plan sponsors strive for greater savings, drug mix becomes even more important.
Using Cutting-Edge Tools to Improve Adherence: PBMs use Drug Utilization Review (DUR) to reduce waste such as polypharmacy and implement patient adherence programs to help patients stick to their prescription regimens. Both programs improve clinical outcomes and influence prescription volume and expenditures.
Improving Quality and Safety: PBMs promote the use of technology like e-prescribing to improve quality and safety by preventing drug duplication and dangerous drug-to-drug interactions.
