In Case You Missed It: Value of Pharmacy Benefit Managers Questioned at Critical Time in Debate

Published Online: Tuesday, March 4, 2014
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March 4, 2014, Alexandria, VA - As the nation's community pharmacists mobilize to fight for the right to serve any Medicare recipient, the nation's largest paper, USA Today takes a critical look at the pharmacy benefit managers opposing the pharmacists' efforts. The following statement may be attributed to B. Douglas Hoey, RPh, MBA, CEO of the National Community Pharmacists Association:

"Across the country independent community pharmacists are fighting for the right to help Medicare recipients fill their prescriptions, but the nation's multi-billion dollar pharmacy benefit managers continue to stand in the way. Currently, Medicare has proposed to give "any willing pharmacy" that can meet a Part D drug plan's terms and conditions the ability to serve seniors. Unfortunately this common sense, money-saving provision is being fought by the PBMs.

"In today's USA Today, a story entitled, "Do drug benefit managers reduce health costs?" by reporter Jayne O'Donnell examines efforts by lawmakers in states across the country to force PBMs to require greater disclosure, especially as the number of Americans who will have access to prescription drugs through health reform increases. Anybody reading the article will clearly see why community pharmacists are fighting for the right to serve seniors with Medicare Part D drug coverage.

"Community pharmacists are opposed to PBMs unilaterally deciding which pharmacies can serve as "preferred pharmacies" and then steering seniors toward them by offering reduced co-pays that don't necessarily reduce overall costs. These exclusive arrangements in a taxpayer-funded program hurt small community pharmacies, and Medicare data shows that preferred pharmacy plans often result in higher costs. Medicare beneficiaries who prefer to visit a community pharmacy should have the opportunity to keep that pharmacist as part of their health care team, particularly since it will not increase the costs to the government to do so.

"We encourage patient rights groups, advocates for seniors and elected officials to support Medicare's "any willing pharmacy" proposals so that we can remove the shadowy middleman between patients and their pharmacists."
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