PCMA reports $1.2 trillion savings as PBMs cover 289 million lives nationwide

During a recent Michigan Legislature meeting, the spotlight was on Pharmacy Benefit Managers (PBMs) and their critical role in managing prescription drug costs. Sean, a representative from the Pharmaceutical Care Management Association (PCMA), presented compelling data highlighting the significant savings PBMs provide to both employers and patients.

PBMs, which serve as intermediaries between insurers, employers, and pharmacies, are responsible for administering prescription drug benefits. They negotiate rebates from drug manufacturers and discounts from pharmacies, resulting in an average savings of $1,154 per covered individual annually. This translates to a staggering projected total savings of $1.2 trillion over the next decade for various entities, including private and public sector employers.

In Michigan alone, PBMs cover approximately 9.3 million lives, with anticipated savings of $33.25 billion over the next ten years, including $2.25 billion for Medicaid. Sean emphasized that despite the implementation of 21 new laws aimed at regulating PBMs, there is skepticism about whether these measures have effectively lowered prescription drug costs.

The discussion also touched on the importance of PBMs in preventing medication errors, with estimates suggesting they could avert one billion such errors over the next decade. This includes correcting prescription mistakes and ensuring patients receive the correct medications at the right dosages.

As the meeting concluded, Sean urged lawmakers to consider the value PBMs bring to the healthcare system, especially in light of ongoing federal discussions about potential reforms. The conversation underscored the need for a deeper understanding of PBMs' impact on drug pricing and patient care as Michigan continues to navigate the complexities of healthcare costs.