PCMA Statement on New OIG Medicare Part D Report

WASHINGTON, June 4, 2018 /PRNewswire-USNewswire/ -- The Pharmaceutical Care Management Association (PCMA) released the following statement on a Medicare Part D report released today by the Office of Inspector (OIG), U.S. Department of Health and Human Services (HHS):

"This report finally debunks the myth that drugmakers have somehow been compelled to raise prices because of the discounts and rebates health plans and PBMs demand to reduce overall costs," said PCMA President and CEO Mark Merritt.

Key findings from the report include:

  • Part D unit costs for brand-name drugs rose nearly 6 times faster than inflation from 2011 to 2015.
  • Despite the substantial growth in rebates, the gap between total reimbursement and total rebates increased from 2011 to 2015.
  • The percentage of brand-name drugs for which manufacturers paid rebates decreased.
  • The number of brand-name drugs with rebates dropped from 72 percent to 61 percent.
  • Increases in Part D unit costs for brand-name drugs led to greater overall Medicare Part D spending and higher beneficiary out-of-pocket costs for these drugs.
  • For nearly half of brand-name drugs reimbursed by Part D from 2011 to 2015, unit costs increased at least 50 percent.
  • The total number of prescriptions for brand-name drugs decreased 17 percent.
  • Brand-name drugs with utilization decreases had greater increases in average unit costs.

PCMA is the national association representing America's pharmacy benefit managers (PBMs). PBMs administer prescription drug plans for more than 266 million Americans who have health insurance from a variety of sponsors including: commercial health plans, self-insured employer plans, union plans, Medicare Part D plans, the Federal Employees Health Benefits Program (FEHBP), state government employee plans, Medicaid plans, and others.

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SOURCE Pharmaceutical Care Management Association


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