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In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.
Pharmacy benefits managers have been increasingly scrutinized for their role in health care costs.
The Pharmaceutical Care Management Association (PCMA) is an American national trade association representing pharmacy benefit managers.According to the association's mission statement, PCMA advocates on behalf of its member companies, which claim to improve affordability of prescription drugs and quality of care through the use of tools such as electronic prescribing (e-prescribing), [1 ...
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The Medicare Prescription Drug, Improvement, and Modernization Act, [1] also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. [2] It produced the largest overhaul of Medicare in the public health program's 38-year history.
The American Medical Association found the average annual savings per physician from digitization to be approximately $1,742. [21] Additionally, a case study by pharmacy benefit manager Prime Therapeutics demonstrated 90% faster payer response time through electronic prior authorization systems compared with the manual prior authorization process.
AMA created the Council on Pharmacy and Chemistry in 1905 to set standards for drug manufacturing and advertising. [37] That same year, the AMA began a voluntary program of drug approval, which would remain in effect until 1955. Drug companies were required to show proof of the effectiveness of their drugs to advertise them in AMA's journal. [38]
Drugs subject to USP standards include both human drugs (prescription, over-the-counter, or otherwise) and animal drugs. USP-NF standards also have a role in US federal law ; a drug or drug ingredient with a name recognized in USP-NF is considered adulterated if it does not satisfy compendial standards for strength, quality, or purity.