PCMA: Sebelius should continue push for cost cuts among state Medicaid programs

WASHINGTON — A group representing the nation’s pharmacy benefit managers said Health and Human Services secretary Kathleen Sebelius should continue encouraging state Medicaid programs to explore affordable pharmacy solutions despite opposition from the independent drug store lobby.

The Pharmaceutical Care Management Association said the current "old-school, fee-for-service" approach used by state Medicaid programs "exposes state governments to political pressure from the independent drug store lobby to set artificially high payment levels," arguing that the focus is on profits instead of patients.

“Medicaid can no longer afford to spend more on pharmacy benefits than Medicare and commercial payers. States should have the flexibility to use the tools other programs use to reduce costs,” said PCMA president and CEO Mark Merritt. “State Medicaid programs can no longer afford to pay pharmacies double or triple what other programs pay.”

The statement from the PCMA followed a document released last week by Sebelius, who urged all 50 state governors to find ways to cut costs through various approaches.