PBMS leverage generics as effective cost-saving tool

Pharmacy benefit managers are becoming increasingly adept at leveraging the power of generics to save client healthcare dollars and improve their own standing, reports indicated.

"The opportunity for lowering costs by promoting generics over brands has never been greater, given the unprecedented number of drugs set to lose patent protection over the next few years," noted the "2012 Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care."

In its "2012 Insights Report," pharmacy and PBM giant CVS Caremark noted that its success at promoting a "high generic dispensing rate worked to drive drug trend down." Behind its ability to boost GDR, the company reported, was "the combination of a stream of patent expirations for blockbuster branded drugs and the company's successful implementation of formulary and plan design strategies to encourage the use of cost-effective generic drugs."

The Pharmaceutical Care Management Association noted, "PBMs use several tools to encourage the use of generic drugs and preferred brands. These include formularies and tiered cost sharing, prior authorization and step therapy protocols, generic incentives, consumer education and physician outreach."

"As PBMs and plan sponsors strive for greater savings, drug mix becomes even more important," association president and CEO Mark Merritt added.

PCMA asserted in a recent report that PBMs will save consumers and payers almost $2 trillion in prescription drug costs over the next decade, in part by promoting generic substitutions at the pharmacy counter.