Bipartisan senate effort encourages Sec. Azar
to address pharmacy DIR
Sens. Shelley Moore Capito (R-W.Va.) and Jon Tester (D-Mont.) are leading a letter to HHS Secretary Alex Azar, urging him to address retroactive pharmacy direct and indirect remuneration fees in Medicare Part D as part of any attempts to lower drug prices. Senators have until July 9 to sign on, so please take a few moments to encourage them to do so through NCPA’s Legislative Action Center.
NCPA also has created sample comments that individuals can personalize and submit to the docket regarding the administration’s RFI and blueprint for lowering prescription drug costs.
NCPA and others file legal brief
in Washington State Medicaid lawsuit
NCPA, along with the National Association of Chain Drug Stores and the Washington State Pharmacy Association, filed a brief with the Washington State Court of Appeals on Wednesday challenging the state's refusal to reimburse community pharmacies for the costs of providing care and services to disadvantaged Medicaid patients. The legal brief states that "because Washington's fees do not reimburse pharmacies for their costs, those fees are dramatically lower than those of any other state in the country," impeding patient access to care.
Senate Finance Committee holds hearing
on drug pricing blueprint
This week, the Senate Finance Committee held a hearing entitled, “Prescription Drug Affordability and Innovation: Addressing Challenges in Today’s Market,” to discuss the Administration’s drug pricing blueprint with Health and Human Services (HHS) Secretary Alex Azar. Chairman Orrin Hatch (R-UT) praised the Administration’s drug pricing blueprint as “comprehensive,” and emphasized his support for market-based solutions rather than government price setting. He urged action to address drug shortages and reconsider the increase in manufacturer obligations in the Medicare Part D coverage gap enacted as part of the Bipartisan Budget Act of 2018. Secretary Azar highlighted the Administration’s interest in eliminating incentives for high list prices, improving competition, enhancing private sector negotiations in Medicare Parts B and D, and stopping anti-competitive or counterproductive efforts by manufacturers and pharmacy benefit managers (PBMs).
Priority house bills gain support in June
NCPA’s top three priority house bills all gained cosponsors in June. H.R. 1038, which addresses retroactive pharmacy DIR fees, picked up the support of Reps. Ed Perlmutter (D-Colo.), Mike Johnson (R-La.), Lee Zeldin (R-N.Y.), Steve Russell (R- Okla.) and Roger Williams (R-Texas) increasing the number of cosponsors to 82. Additionally, Rep. Ralph Abraham (R-La.) became the 51st cosponsor of H.R. 1316, MAC transparency legislation. Rep. Abraham also cosponsored H.R. 1939, any willing pharmacy legislation, along with Rep. Jamie Raskin (D-Md.) bringing the cosponsorship total to 34. If you are represented by any of these members, please click here to send them an email thanking them for their leadership and support.
Current Cosponsorship numbers for all priority bills are:
- Pharmacy DIR fees: S. 413: 14 Senators / H.R. 1038: 82 Representatives
- Generic drug pricing transparency (or MAC legislation): H.R. 1316: 51 Representatives
- Pharmacy choice in Medicare Part D: S. 1044: 5 Senators / H.R. 1939: 34 Representatives
- Provider status: S. 109: 52 Senators / H.R. 592: 278 Representatives
- Compounding: H.R. 2871: 55 Representatives
Click here to download an Excel spreadsheet of the cosponsorship matrix to see what each legislator is currently supporting.
NCPA meets with TRICARE officials
This week NCPA staff met with the Department of Defense Health Affairs to discuss price parity in the purchasing of brand name medications in the TRICARE program. Attendees included representatives from the pharmaceutical manufacturers, Express Scripts, and the chain drugstores. The Department of Defense Health Affairs is considering options that would level the playing field between retail and mail order pharmacy in regards to the costs of brand name medications. NCPA will remain engaged in discussions to ensure that TRICARE beneficiaries can access prescriptions and care from their local pharmacies.
NCPA participates on drug pricing panel
at NALEO annual meeting
NCPA’s Scott Brunner participated in a panel discussion on drug pricing last week at the National Association of Latino Elected Officials’ annual meeting in Phoenix. Representatives of PhRMA, Kaiser Permanente, PCMA and the American Cancer Society’s Cancer Action Network were also panelists. While much of the conversation was focused on the role of rebates in drug pricing, Brunner spoke of the money PBMs extract out-of-sight: retroactive fees, driving patients to mail order, and lucrative-but-opaque Medicaid contracts – which disadvantage patients, pharmacies, and tax payers.
CMS rejects Massachusetts’ request to limit drug coverage;
approves Oklahoma’s value-based plan
This week, CMS rejected Massachusetts’ request to limit prescription drug coverage in its Medicaid program. Through a waiver request, Massachusetts attempted to mirror a private insurance model, a limited formulary of drugs. CMS asserted that it would allow Massachusetts to exclude coverage of specific drugs only if the state negotiated with pharmaceutical companies directly and did not receive automatic rebates required by Medicaid. Oklahoma, however, was successful in receiving CMS approval for its Medicaid state plan amendment (SPA) to permit the state “to negotiate supplemental rebate agreements involving value-based purchasing arrangements with drug manufacturers that could produce extra rebates for the state if clinical outcomes are not achieved.”
GAO report addresses non-compliance with 340B
in contract pharmacies
The Governmental Accountability Office (GAO) released a report entitled, “Drug Discount Program: Federal Oversight of Compliance at 340B Contract Pharmacies Needs Improvement.” After reviewing 30 contracts by 55 covered entities, the GAO found that the Health Resources and Services Administration (HRSA) had weak oversight of this program that has been hindering its ability to ensure compliance with 340B at contract pharmacies. HRSA presented a document that included best practices for covered entities to resolve non-compliance with 340B in contract pharmacies. The full GAO report can be found here: https://www.gao.gov/products/GAO-18-480.
***Note: This weekly update will not be sent on July 6 and will resume on July 13.
NCPA’s Advocacy Center Update provides a weekly detailed summary of recent and breaking legislative, regulatory, and state developments impacting independent community pharmacy and NCPA’s efforts to affect policies benefitting its membership and the industry. The weekly update is distributed to NCPA leadership, steering committees, allied organizations/stakeholders and major contributors to the NCPA LDF and PAC.