Study finds restricting mail-service could up costs

June 12, 2006

Pennsylvania bill H.B. 814 could increase the state's consumers' and employers' prescription drug costs by as much as $123 million annually, according to new study from the actuarial firm Milliman and released by PCMA. The bill calls for proposed restrictions on consumers' and employers' ability to choose the mail-service pharmacy option and also eliminates co-pay differentials between retail and mail-service prescriptions.

Study finds restricting mail-service could up costs

Pennsylvania bill H.B. 814 could increase the state's consumers' and employers' prescription drug costs by as much as $123 million annually, according to new study from the actuarial firm Milliman and released by PCMA. The bill calls for proposed restrictions on consumers' and employers' ability to choose the mail-service pharmacy option and also eliminates co-pay differentials between retail and mail-service prescriptions. According to the study, the provisions in the bill could raise prescription drug benefit costs by 2.3% to 4.7% per year, amounting to an increase of $60 million to $123 million in 2006 for both purchasers and consumers. PCMA believes the bill is designed to "protect the drugstore lobby from competition in the marketplace." PCMA president Mark Merritt said in a conference call, "The bill is a hidden tax that will increase drugs costs for Pennsylvania consumers and employers while driving up drugstore profits. The mail-service pharmacy option provides significant savings-typically about two-thirds the amount of cost-sharing of prescription drugs at a retail pharmacy." Responding to the new study, NCPA Executive VP and CEO Bruce Roberts commented, "What the PCMA release doesn't say is that many health plans offer a 90-day prescription from community pharmacies. What's more important, however, is that the co-pay represents a fraction of the real cost of a prescription, and that's a cost we all pay for. It appears to be state lawmakers, prosecutors, and the courts that believe the giant PBM." He added that there's a conflict of interest created when PBMs own mail-order pharmacies. This is what's in need of reform, he contended.

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