PCMA Response to New York Times Article on Biotech Medicine Costs

WASHINGTON, April 18 /PRNewswire-USNewswire/ -- The Pharmaceutical Care
Management Association (PCMA) issued the following statement today regarding a
story to be published in tomorrow's New York Times:
"The New York Times has missed another opportunity to explain the real
reasons behind increased spending on biotech medications. In the April 14,
2008 piece, 'Co-payments Soar for Drugs with High Prices,' the Times blames
employers and plan sponsors for the high cost of biotech treatments. Then, in
a piece dated tomorrow, 'Paid to Control Costs, Yet Pushing Some Prices
Higher,' the Times blames high prices on those who dispense biotech products
and manage related care. Meanwhile, both articles strangely downplay the role
of those who actually set prices: the biotech manufacturers. They also ignore
the fact that spending has increased because more patients have access to
these life-saving medicines than ever before.
"Below are four fundamental issues the Times has either neglected or
ignored:
-- First, the Times confuses those who price the biotech products (biotech
manufacturers) with those who dispense them (specialty pharmacies). It's
unfair to quote a source saying that benefit managers 'can raise prices at
will' when manufacturers, not specialty pharmacies, set the prices for these
products.
-- Second, the article virtually ignores that a key reason for high
biotech prices is a legal loophole that protects biotech manufacturers from
generic competition. Unlike traditional pharmaceuticals, there is no clear
regulatory pathway for the FDA to approve generic versions of biotech
products. For years, specialty pharmacies and pharmacy benefit managers (PBMs)
have been fighting for legislation to allow biogenerics and competition to
bring down biotech prices.
-- Third, the Times fails to report that more patients now have greater
access to these products than ever before. That's good news, but it also
costs more. Nearly 60 percent of the increase in spending on specialty
biotech products last year was due to increased utilization, not price
increases.
-- Fourth, the article distorts the role of limited distribution networks,
which only apply to less than 2 percent of biotech prescriptions, specifically
for treatments used by very small patient populations. These small populations
often require extremely specialized care, such as infusions administered by
highly trained nurses. This care prevents side-effects, reduces product
wastage, and monitors possible inappropriate utilization.
Traditional wholesaler and retail networks are simply not equipped to
provide this specialized and targeted care. To imply that limited distribution
networks are somehow the cause of higher prices is grossly misleading.
In fact, the FDA requires that certain drugs be limited to one pharmacy
due to special circumstances surrounding the medications."
PCMA is the national association representing America's pharmacy benefit
managers (PBMs), which administer prescription drug plans for more than 210
million Americans with health coverage provided through Fortune 500 employers,
health insurance plans, labor unions, and Medicare Part D.
SOURCE Pharmaceutical Care Management Association

Charles Cote of Pharmaceutical Care Management Association, +1-202-207-3605