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Pharmaceutical Care Management Association (PCMA)

The Pharmaceutical Care Management Association is the national association representing America's pharmacy benefit managers (PBMs).

https://www.pcmanet.org/


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About Us I Pharmaceutical Care Management Association | PCMA

The Pharmaceutical Care Management Association (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 ...

https://www.pcmanet.org/about/


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Become a PCMA Member | PCMA

Ten reasons why joining PCMA is vital to your company’s strategic interests: 1. SET INDUSTRY DIRECTION. PCMA’s members shape the industry’s direction and positions on a broad range of public policy issues that affect your business.

https://www.pcmanet.org/about/members/become-a-member/


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PCMA Annual Meeting 2020 | PCMA

2020-09-14 00:00 2020-09-15 23:59 America/New_York PCMA Annual Meeting 2020 The Annual Meeting is the industry’s premier executive conference. The event is tailored specifically for senior executives from PBMs and their affiliated business partners – most notable drug manufacturers.

https://www.pcmanet.org/pcma-event/annual-meeting-2020/


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PCMA Members | PCMA

A few of our members include CVS Health, Optum Rx, Evolve Pharmacy Solutions, Cigna Pharmacy Management and much more.

https://www.pcmanet.org/about/members/


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Speakers | PCMA

2020-09-14 00:00 2020-09-15 23:59 America/New_York PCMA Annual Meeting 2020 The Annual Meeting is the industry’s premier executive conference. The event is tailored specifically for senior executives from PBMs and their affiliated business partners – most notable drug manufacturers.

https://www.pcmanet.org/pcma-event/annual-meeting-2020/speakers/


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PCMA Statement on House Drug Pricing Legislation | PCMA

September 19, 2019 (Washington, D.C.) — Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott issued the following statement on the House Democrats drug pricing legislation: “We appreciate House Speaker Nancy Pelosi’s and the House Democratic leadership’s focus on reducing prescription drug prices, specifically for medications that do not face competition in the ...

https://www.pcmanet.org/pcma-statement-on-house-drug-pricing-legislation/


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COVID-19: How PBMs Are Helping Patients and Health Plans

COVID-19: Principles on Patient Access to Prescription Drugs. During this public health emergency, PBMs are committed to helping the patients we serve practice social distancing and stay at home safely with convenient, reliable access to their needed prescription drugs.

https://www.pcmanet.org/covid-19-how-pbms-are-helping-patients-and-health-plans/


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COVID-19: How PBMs Are Helping Patients and Health Plans ...

PBM Principles on Patient Access to Prescription Drugs During the COVID-19 Pandemic During this public health emergency, PBMs are committed to helping the patients we serve practice social distancing and stay at home safely with convenient, reliable access to their needed prescription drugs.

https://www.pcmanet.org/policy-issues/covid-19-how-pbms-are-helping-patients-and-health-plans/


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PCMA Statement on Administration's Executive Order on ...

(Washington, D.C.) — Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott issued the following statement on the Administration’s Executive Order to resurrect the rebate rule. “The Administration’s decision last year to withdraw a proposed regulation on prescription drug re

https://www.pcmanet.org/pcma-statement-on-administrations-executive-order-on-prescription-drug-pricing/


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What is a specialty pharmacy network? | PCMA

Specialty Networks. A core PBM management tool is the establishment and maintenance of pharmacy networks. A network consists of pharmacies that have entered into an agreement with a PBM to dispense prescriptions to enrollees of the health plans that PBMs work with.

https://www.pcmanet.org/pcma-cardstack/what-is-a-specialty-pharmacy-network/


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What is a specialty drug? | PCMA

Overview. The definition of a specialty drug continues to evolve as the specialty drug pipeline advances and expands. These drugs are best defined by the full range of each product’s attributes, rather than solely by cost and route of administration.

https://www.pcmanet.org/pcma-cardstack/what-is-a-specialty-drug/


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PCMA Statement on Medicare Part D Premiums | PCMA

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 ...

https://www.pcmanet.org/pcma-statement-on-medicare-part-d-premiums/


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Pharmacy Benefit Managers (PBMs): Generating Savings for ...

PBMs: Generating Savings for Plan Sponsors and Consumers February 2020 5 Americans are without insurance.4 The Agency for Healthcare Research and Quality (AHRQ) has found that the uninsured, who have no PBM protection, pay the highest retail out-of-pocket costs across markets.5 PBMs and their clients guide how actively pharmacy benefits are managed within the context of applicable

https://www.pcmanet.org/wp-content/uploads/2020/02/Pharmacy-Benefit-Managers-Generating-Savings-for-Plan-Sponsors-and-Consumers-2020-1.pdf


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Events | PCMA

2021-09-20 07:00 2021-09-21 22:00 America/New_York Annual Meeting 2021 The PCMA Annual Meeting is the industry’s premier executive conference. The event provides an un-matched and ideal venue for senior executives from PBMs, specialty pharmacy, payer organizations, and pharmaceutical manufacturers to network, conduct business and learn about the most current issues impacting the industry.

https://www.pcmanet.org/events/


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Independent Pharmacies in the U.S. are More on the Rise ...

4 Table 2. Growth (or Loss) Rate of Independent Pharmacies by State, 2010-2019 State Percent Change Absolute Change Total Number in 2019 Total US 13% 2,634 23,061

https://www.pcmanet.org/wp-content/uploads/2020/03/FINAL_Independent-Pharmacies-in-the-U.S.-are-More-on-the-Rise-than-on-the-Decline.pdf


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Agenda | PCMA

6:00 am - 9:00 pm ET: Virtual Meeting Rooms Open. On Demand Sessions: Welcome Remarks JC Scott, President & Chief Executive Officer, PCMA Brian McCarthy, Chief Strategy and Business Operations Officer, PCMA The Long Game Strategy for Transforming Pharmacy from Volume to Value – A Call to Action for all Stakeholders

https://www.pcmanet.org/pcma-event/annual-meeting-2020/agenda/


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Pharmacy Contracting & Reimbursement | PCMA

PBMs contract with pharmacies on behalf of health plans and employers to serve patients by building networks of preferred pharmacies. As part of the negotiations to become a preferred network provider, pharmacies and PBMs negotiate contract types, payment rates for medications, and the responsibilities of both parties.

https://www.pcmanet.org/policy-issues/pharmacy-contracting-reimbursement/


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PCMA Spring Webinar Series 2020 | PCMA

The PCMA Annual Meeting is the industry's premier executive conference. The event provides an un-matched and ideal venue for senior executives from PBMs, specialty pharmacy, payer organizations, and pharmaceutical manufacturers to network, conduct business and learn about the most current issues imp

https://www.pcmanet.org/pcma-event/pcma-spring-webinar-series-2020/


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PCMA Statement on the United States Supreme Court Decision ...

(Washington, D.C.) — Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott released the following statement on the United States Supreme Court’s decision to review Rutledge v. PCMA: “The Employee Retirement Income Security Act (ERISA) has long enabled employers to provide c

https://www.pcmanet.org/pcma-statement-on-the-united-states-supreme-court-decision-to-review-rutledge-v-pcma/


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Virtual Platform | PCMA

2020-09-14 00:00 2020-09-15 23:59 America/New_York PCMA Annual Meeting 2020 The Annual Meeting is the industry’s premier executive conference. The event is tailored specifically for senior executives from PBMs and their affiliated business partners – most notable drug manufacturers.

https://www.pcmanet.org/pcma-event/annual-meeting-2020/virtual-platform/


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Card Stacks | PCMA

Specialty pharmacies were established in direct response to the industry’s need to better procure, store, and dispense specialty drugs, as well as better manage therapy for patients on specialty drugs.

https://www.pcmanet.org/card-stacks/


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Additional Resources | PCMA

PCMA Statement on Administration’s Executive Order on Prescription Drug Pricing. July 24, 2020 (Washington, D.C.) — Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott issued the following statement on the Administration’s...

https://www.pcmanet.org/resources/


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Drug Price Negotiations & Rebates | PCMA

The pandemic is having a devastating impact on America’s seniors. The Medicare Part D prescription drug program provides our nation’s seniors with affordable drug coverage, which is more important now than ever. However, the Administration would threaten to destabilize the Medicare Part D program by dramatically increasing premiums for the vast majority of Part D enrollees.

https://www.pcmanet.org/policy-issues/drug-price-negotiations-rebates-2/


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Drug Cost Management | PCMA

The management of high cost drugs is receiving increased attention from patients, providers, payers, and policymakers due to ongoing drug price increases and the aggregate impact on health care costs.

https://www.pcmanet.org/policy-issues/drug-cost-management/


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PCMA Statement on Administration's Model for Insulin ...

March 11, 2020 (Washington, D.C.) — Pharmaceutical Care Management Association (PCMA) President and CEO JC Scott issued the following statement regarding today’s announcement from the Centers for Medicare and Medicaid Services’ “Part D Senior Savings Model” for insulin: “While we are still reviewing the details of the Part D Senior Savings Model, we commend the Administration for ...

https://www.pcmanet.org/pcma-statement-on-administrations-model-for-insulin-savings-in-medicare/


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Specialty Pharmacy Infographic | PCMA

This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website.

https://www.pcmanet.org/our-industry/specialty-pharmacy-infographic/


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Drew Asher | PCMA

CEO, Envolve Pharmacy Solutions. Drew Asher serves as Executive Vice President, Envolve Specialty, for Centene Corporation, a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals.

https://www.pcmanet.org/about/board-of-directors/drew-asher/


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Regina Stivers | PCMA

Regina Stivers is Director, State Affairs at PCMA. In this role, she advocates on behalf of PCMA’s member companies in the Mountain West and South Central regions with policy development, legislative activity and coordination of member company state activities.

https://www.pcmanet.org/about/pcma-staff/regina-stivers/


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Podcast: The Impact of COVID-19 on the Pharmaceutical ...

JC Scott speaks with Doug Long, Vice President of Industry Relations at IQVIA, about the impact of COVID-19 on the pharmaceutical market. IQVIA is a world leader in using data, technology, advanced analytics and expertise to help customers drive healthcare – and human health – forward.

https://www.pcmanet.org/podcasts-the-impact-of-covid-19-on-the-pharmaceutical-market/


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What is a formulary? | PCMA

What's a formulary? Among the most important tools used by PBMs to manage specialty drug costs are drug formularies. A formulary is a continually updated list of prescription drugs approved for reimbursement by the PBM’s payer client.

https://www.pcmanet.org/pcma-cardstack/what-is-a-formulary/


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What is a PBM and what do they do? | PCMA

Pharmacy Benefit Managers (PBMs) administer prescription drug plans for more than 270 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, managed Medicaid plans, and others.

https://www.pcmanet.org/our-industry/


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PCMA Launches Next Phase of Ad Campaign: Reviving HHS ...

(Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) is announcing the launch of the next series of ads as part of the TV and digital advertising campaign on the Administration’s plans to revive the so-called rebate rule. View the new TV ad. “President Trump made the rig

https://www.pcmanet.org/pcma-launches-next-phase-of-ad-campaign-reviving-hhs-rebate-rule-will-significantly-raise-medicare-premiums-and-federal-spending/


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New Report Confirms Proposed "Rebate Rule" Would Raise ...

September 8, 2020 (Washington, D.C.) — A new report, “Negative Economic Impact of Restricting Rebates in Medicare Part D,” by Alex Brill of Matrix Global Advisors (MGA), examines recent evidence showing that prescription drug rebates negotiated by pharmacy benefit managers (PBMs) reduce drug costs and lower premiums in Medicare Part D.

https://www.pcmanet.org/new-report-confirms-proposed-rebate-rule-would-raise-medicare-premiums-and-taxpayer-costs/


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Ken Paulus of Prime Therapeutics Becomes Chairman of PCMA ...

(Washington, D.C.) — Today, the Pharmaceutical Care Management Association (PCMA) announced Ken Paulus, President and CEO of Prime Therapeutics, as its new chairman of the Board. “I’m honored to take on this role within our industry at this important time,” said Mr. Paulus. “As we continue to dea

https://www.pcmanet.org/ken-paulus-of-prime-therapeutics-becomes-chairman-of-pcma-board-of-directors/


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Just the Facts: Pharmacy Direct and Indirect Remuneration ...

February 27, 2020 . During the Energy and Commerce Health Subcommittee hearing on “The Fiscal Year 2021 HHS Budget and Oversight of the Coronavirus Outbreak” several inaccurate remarks were made on pharmacy direct and indirect remuneration (DIR). What is Pharmacy DIR? Pharmacy benefit managers (PBMs) and Part D plan sponsors use pharmacy DIR to create high-quality, value-based pharmacy ...

https://www.pcmanet.org/just-the-facts-pharmacy-direct-and-indirect-remuneration-increases-value-and-improves-quality/


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PCMA Annual Meeting 2019 | PCMA

The program will begin with a 45-minute workshop lead by Margaret Neale, Professor, Emerita at the Graduate School of Business, Stanford University, and co-author of Getting (More of) What You Want: How the Secrets of Economics and Psychology Can Help You Negotiate Anything, in Business and in Life.. Professor Margaret Neale will explore the challenges we face when negotiating, and share how ...

https://www.pcmanet.org/events/past-events/pcma-annual-meeting-2019/


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Pharmacy Benefit Managers Advocate on Behalf of ...

July 11, 2019 (Washington, D.C.) — The Pharmaceutical Care Management Association (PCMA) released the following statement on today’s hearing in the Massachusetts House Committee on Post Audit and Oversight: “We applaud Massachusetts legislators for examining prescription drug pricing and share the objective of reducing drug costs.

https://www.pcmanet.org/pharmacy-benefit-managers-advocate-on-behalf-of-massachusetts-consumers-to-reduce-prescription-drug-costs/


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Antitrust Considerations of Proposals to Limit Rebates

4 pricing.15 In the settlement agreement, the drug manufacturers agreed that, with limited exceptions, they would offer retail pharmacies the same discounts offered to managed care payers.16 While the litigation challenged the manufacturers’ upfront discount practices, the use of

https://www.pcmanet.org/wp-content/uploads/2018/07/Legal-Analysis_-Antitrust-Considerations-of-Proposals-to-Limit-Rebates.pdf


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Sponsors | PCMA

2020-09-14 00:00 2020-09-15 23:59 America/New_York PCMA Annual Meeting 2020 The Annual Meeting is the industry’s premier executive conference. The event is tailored specifically for senior executives from PBMs and their affiliated business partners – most notable drug manufacturers.

https://www.pcmanet.org/pcma-event/annual-meeting-2020/sponsors/