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NM coalition tackles rising drug costs

ALBUQUERQUE, N.M. — Several prescriptions for alleviating the headache of rising drug costs were outlined Tuesday at a forum sponsored by the New Mexico Coalition for Healthcare Value.

The forum was meant to address the expanding cost of prescription medications, which make up an estimated 20 percent of overall personal health care services paid by employers and insurers. The event drew 100 people to the Albuquerque International Balloon Museum.

Last year alone, estimates from the IMS Institute for Healthcare Informatics showed spending increased 13 percent, with the overall price tag for prescription drugs roughly $225 billion, according to statistics supplied by the event organizer.

The increasing cost of prescription drugs in the United States has become a source of growing concern for patients, prescribers, payers and policymakers, said Pat Montoya, the coalition’s executive director.

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“There is an influx of new specialty drugs and even higher-cost generics that are driving this increased cost trend,” said Montoya, who leads a nonprofit organization made up of employers who pick up the tab for the health care needs of 200,000 state residents, including public employees.

The coalition has set its sights on working toward solutions on controlling pharmacy costs through ongoing education, information and networking events. “This is not a one-off,” said Montoya.

She pointed out that:

— One out of every 10 health care dollars spent is for prescriptions, and the cost is rising.

— 113 million Americans take a prescribed drug.

— Annual out -of-pocket costs are at $790 per person.

— 11 percent of Americans spend $1,200 or more a year on prescriptions.

The keynote speaker touched on the role of pharmacy benefit management organizations, which use their collective buying power to obtain discounts from pharmacies and rebates from drugmakers, said Sumit Dutta, chief medical officer for OptumRX. OptumRX is the designated benefit management organization for insurer UnitedHealthcare. He said the organizations employ doctors, pharmacists and data analysts focused on researching and making recommendations on the safety and efficacy of medications to avoid health risks and financial impacts for people.

Over the next 10 years, such management organizations are projected to save employers and health plans nearly $654 billion, according to the Pharmaceutical Care Management Association. A breakout of cost savings in New Mexico was not available.


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