Partner Login Pharmacy Login Call (800) 928-4301

Meeting an “Unfilled” Need: The Important Role of PBMs in Health Care Reform

The enactment of the Affordable Care Act has placed the United States on a path to nearly universal health insurance coverage. As reform implementation continues to progress on both a national and state level, the entire health care industry is monitoring its evolution, which will bring both opportunities and challenges. Many questions of the full impact on businesses and individuals still remain.

The Congressional Budget Office projects that the combination of new appropriations for health insurance and consumer protections will enable 14 million uninsured Americans to gain coverage in 2014, and an additional 27 million by 2021. Compounding these statistics, the U.S. Census Bureau estimates that the U.S. population over 65 years of age will grow by nearly 80 percent in the next 20 years.

The Prescription Benefits Management (PBM) industry is also monitoring the implementation of the reform, as prescription drugs are often one of the first medical purchases made by newly insured individuals, and those 65 and older fill an average of 25 prescriptions annually, approximately three times the national average.

Yet all observers agree that this evolution will not happen rapidly, and these millions of individuals will not receive affordable health care access overnight. It will be a continuing process, and it is important that the industry continues to address the need for affordable prescription drugs throughout the transition.

In fact, approximately 84 million Americans, which represent almost half of all working-age adults in the United States, are currently uninsured or under-insured and forgoing necessary health care measures because they simply cannot afford it.

As implementation of the Affordable Care Act unfolds, it is more important than ever to ensure that the industry continues to meet the needs of consumers today – and the anticipated growth in consumer prescription demand – in a cost efficient manner.

The Paramount Rx Prescription Discount Program aims to do its part by continuing to provide cost effective solutions for the millions of people struggling with escalating medical expenses. The program has consistently provided consumers with equal opportunity access to affordable prescription drugs with no exclusions for pre-existing health conditions, deductibles or maximum benefit levels. Regardless of the state of reform, Paramount Rx is committed to the continued provision of this consumer-driven health care solution today and into the future.

Comments are closed