PCMA: New Study Highlights 'Market-Based' Reforms to Lower Part D Drug Prices

As US policymakers seek 'offsets' to finance health reform, a new study released in Health Affairs ('How Medicare Could Get Better Prices on Prescription Drugs'), highlights several market-based reforms for Medicare Part D which could reduce government spending, according to the Pharmaceutical Care Management Association (PCMA, which represents the nation's pharmacy benefit managers.

'These reform options - including allowing Part D plans and pharmacy benefit managers greater negotiating leverage and expanding generic substitution - are 'real' reforms in health care that would lower costs and increase access, without shifting costs from the federal government to the private sector,' said PCMA President and chief executive Mark Merritt.

The study also critiques other options that have been debated for Part D, including allowing the government to negotiate directly on drug prices and imposing Medicaid-style rebates. The authors note that 'the structure of Part D, replete with many private plans, poses difficult administrative and practical hurdles to successful Federal price negotiations.' Mandatory rebates in Part D would be 'prone to gaming by companies and politically expedient adjustments by Congress,' according to the study.