Coalition seeks to preserve managed pharmacy techniques

By Karen Pallarito

NEW YORK (Reuters Health) – As debate over a Medicare pharmacy benefit continues, a coalition of employers, health plans, drug benefit managers, and others has come together to advocate for "market-based" approaches to managing prescription drug benefits.

Members of the newly launched Rx Benefits Coalition say that preserving market innovations, such as the use of formularies, generics and prescription mail-order services, is essential to ensuring that consumers have access to safe and affordable prescription medications.

"This group was formed in response to rising healthcare costs and threats to marketplace innovations that managed care pharmacy has developed and uses," explained Judith A. Cahill, executive director of the Academy of Managed Care Pharmacy, a coalition member.

Although the Rx Benefits Coalition won't take a stand on any particular piece of legislation, it will be active in informing the ongoing debate over the creation of a Medicare prescription drug benefit, Cahill told Reuters Health.

Anne Canfield, a lobbyist who helped organize the coalition, said that members are already beginning to see managed care techniques, such as home delivery of drugs and the use of formularies, coming under attack in the states. The fear is that federal lawmakers will embrace similar restrictions on managed care as part of a Medicare drug benefit.

The coalition hopes to beat those attacks to the punch by teaching policymakers how managed care can save money and improve patient care. "If there are pieces of legislation that in some way damage or restrict the use of those tools, we would probably get involved in trying to get people to understand why that's not a good idea," she told Reuters Health.

It doesn't make a lot of sense from a cost perspective for states grappling with rising Medicaid drug costs to limit the use of managed care tools, Canfield said. "And probably more importantly it doesn't make any sense from a safety perspective for the patient."

The coalition's 23 members include the US Chamber of Commerce, the Health Insurance Association of America, the nation's three largest pharmacy benefits management companies and a handful of the leading managed health plans.

The drug industry's lobbying organization, the Pharmaceutical Research and Manufacturers of America, said that it supports the coalition's goal of ensuring that patients have access to affordable drug coverage and quality pharmaceutical care though a competitive system.

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