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Mail-Service Pharmacies Can Save Medicare $86
Billion on Prescription Drug Costs
Aug. 2, 2005 With savings of 10 percent compared
to retail pharmacies, the mail-service pharmacy option has the potential
to save Medicare as much as $86 billion dollars on prescription drug
costs over the next decade, according to a new study by the Lewin Group
released today by the Pharmaceutical Care Management Association (PCMA).
PCMA is the national association representing America's pharmacy benefit
managers (PBMs).
While patients with short-term acute care needs
typically receive their prescriptions in the retail setting, those
patients with chronic conditions such as high-blood pressure and high
cholesterol could be better served by the home delivery option offered
by mail-service pharmacies, says the PCMA.
The mail-service pharmacy option offers increased
savings and, since medications can be automatically delivered as each
fill ends, helps consumers better comply with their prescription
regimen. Furthermore, mail-service pharmacies have pharmacists available
over the phone 24/7 to assure consumers the ability to ask and get the
answers for any questions they may have about their medications, they
say.
Taken together, mail-service pharmacy satisfaction
scores very high in terms of the condition of the drugs received,
correct drugs delivered, and ease of refilling prescriptions, according
to a 2004 survey of consumers in mail-service pharmacy. In 2006, Lewin
estimates that the mail-service pharmacy penetration rate will be about
23.6 percent of the Medicare population, says the news release by the
PCMA.
"Mail-service pharmacy is a 'win-win' scenario for
seniors and policymakers looking to improve Medicare and put it on a
more sound fiscal footing," said PCMA President Mark Merritt. "Some of
the reasons that seniors with chronic conditions don't yet use mail is
because they are unfamiliar with it, don't understand how it could help
them, and don't know how to access it. To the degree the mail-service
pharmacy option can be more aggressively promoted and accepted, the
better off seniors will be and better off the Medicare program will be."
Among the key findings from the Lewin study:
-- Lewin estimates that mail-service pharmacies
provide savings of 10 percent compared to retail pharmacies based on a
review of the published evidence.
-- At its current level of market penetration,
mail-service will save the health care system $78.9 billion in drug
expenditures from 2006-2015. This includes $44.3 billion for Medicare
and $34.6 billion for the commercial sector.
-- If all prescriptions that could appropriately be
filled through mail-service were filled through mail-service, Lewin
estimates that drug expenditures would be reduced by an additional $99
billion from 2006 to 2015. This includes $42.2 billion for Medicare and
$56.8 billion for the commercial sector.
-- The cumulative savings that mail-service
pharmacies could provide the health system during the next ten years
amounts to $177.9 billion, based on existing and potential mail-service
market penetration.
The complete Lewin study, "Mail-Service Pharmacy
Savings: A Ten-Year Outlook for Public and Private Healthcare
Purchasers," is available on PCMA's Web site at
http://www.pcmanet.org.
About Pharmacy Benefit Managers (self
description)
PBMs administer prescription drug plans for more
than 200 million Americans with prescription drug coverage provided
through the nations small and large employers, Taft-Hartley union
plans, health insurers, state and federal-employee benefit plans, and
Medicare Advantage health plans. PBMs help drive down the cost of
prescription drugs for consumers and plan sponsors on average by 25
percent by negotiating discounts with drug manufacturers and retail
pharmacies. These savings are, in turn, passed on to consumers. PBMs
also provide consumers with important quality protections, such as
disease management and physician and patient education.
PricewaterhouseCoopers estimates that PBMs will save consumers and
employers $1.3 trillion dollars on prescription drug costs over the next
decade.
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