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New Report: Drugstore Networks Could Save Employers, Medicare, and Medicaid $115 Billion
Date:1/28/2013

policies.  These are laws and regulations that force plans to contract with pharmacies that don't meet their quality standards or geographic access needs. According to the Federal Trade Commission, such policies discourage competition and limit access to affordable healthcare.
  • Drugstore payments in Medicaid set by political officials, not market forces.  State government officials set pharmacy reimbursement rates for Medicaid that are often higher than those negotiated by health plans in Medicare and the commercial market. When plans are not allowed to negotiate, drugstores have less incentive to offer discounts in exchange for being included in networks.
  • Litigation by independent drugstores.  Independent drugstores have launched a wave of lawsuits aimed at hobbling the ability of Medicaid and Medicare to implement preferred and limited pharmacy networks.
  • PCMA represents the nation's pharmacy benefit managers (PBMs), which improve affordability and quality of care through the use of electronic prescribing (e-prescribing), generic alternatives, mail-service pharmacies, and other innovative tools for 215 million Americans.

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    SOURCE Pharmaceutical Care Management Association
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