Alexandria, Va. - July 11, 2012
A new video and website offer health plan sponsors (i.e., employers, unions, government programs, etc.), policymakers and patients resources to get the most out of their prescription drug benefit and to reduce unnecessary spending, the National Community Pharmacists Association (NCPA) announced today. At the website www.whorunsmydrugplan.com, visitors can learn about common practices of giant pharmacy benefit managers (PBMs), who are hired to administer drug plans and negotiate prices for payers, but drive up health insurance costs and restrict patient choice. There they can also watch "The Third Wheel," a video that takes a humorous look at how prescription middlemen affect consumers' prescription benefit by inserting themselves into the relationship between patients, doctors and pharmacists.
"Too many plan sponsors, policymakers and patients remain unaware of how large pharmacy benefit managers affect their prescription drug benefit and their health care premiums," said NCPA CEO B. Douglas Hoey, RPh, MBA. "For too long, the PBM industry has benefitted from a lack of oversight and regulation, which has eroded the value of the prescription drug benefit to consumers. We have seen prescription drug costs rise, insurance premiums and patient copayments increase, higher PBM profits and diminished patient choice—while reimbursement to pharmacy small business owners for providing prescription drug services continues to decline. It's fair to ask: Where's the money going?"
Whorunsmydrugplan.com answers the basic question, "What is a PBM?" and explains cost-inflating PBM practices under titles such as "Spread Pricing," "Rebate Pumping," "Restricting Patient Choice," "Mail Order False Economics," and "Mail Order Is Not For Everyone." The site also provides a "take action" page for patients and health plan sponsors as well as a resources page linking to other websites, including those of consumer advocates that have expressed similar concerns with PBMs.
"These new online resources are intended to help enable plan sponsors, policymakers and patients to further examine these issues and to insist on meaningful reforms," Hoey added. "Simply put, the outdated drug benefit business model of today should be replaced with health plan designs that are aligned to the interests of payers and patients, while properly utilizing pharmacists to reduce costs and improve health outcomes."
For example, pharmacists help reduce costs through maximizing the appropriate use of low-cost generic drugs and by countering the $290 billion problem of patients who don't take their medication as prescribed by a doctor. While community pharmacists have proven to be successful in both areas, their effectiveness is undermined by common giant PBM practices such as limiting patients' access to community pharmacies and requiring patients to use PBM-owned mail order pharmacies.
Hoey concluded, "We hope everyone who visits this website or watches this video will spread the word with others in support for common-sense reforms. As the saying goes, the one who holds the purse strings holds the power. Payers, and ultimately consumers, hold that power to get the value they deserve from their prescription drug benefit. These resources will help remind them of that dynamic."
The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies. Together they represent a $93 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 315,000 people, including 62,400 pharmacists. Independent community pharmacists are readily accessible medication experts who can help lower health care spending. They are committed to maximizing the appropriate use of lower-cost generic drugs and reducing the estimated $290 billion that is wasted annually by improper medication use. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.
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