New independent study links pharmacy closures
to lower adherence rates
Pharmacy closures have a significant impact on adherence to essential heart medications among older U.S. adults, according to a new study published in JAMA Network Open. The study examined claims data of patients who were 50 years of age or older and who had filled prescriptions for cardiovascular medications. The sample included patients of pharmacies that closed. The study found that adherence rates among all patients was similar while pharmacies remained open. However, after a pharmacy closed, adherence rates of those patients dropped significantly. Drops in adherence were greatest among patients using independent pharmacies, filling prescriptions at a single store, or living in low-access areas with fewer pharmacies.
The authors of the study concluded, “Efforts to reduce nonadherence to prescription medications should consider the role of pharmacy closures, especially among patients at highest risk,” the study authors emphasized. They also stressed the importance of pharmacy reimbursement for prescription medications as a way to reduce the number of at-risk pharmacy closures.
Rep. Peter Welch announces intention
to introduce bipartisan pro-pharmacy legislation
This week, Rep. Peter Welch (D-Vt.) announced plans to introduce legislation aimed at lowering drug prices during a visit to NCPA member Rutland Pharmacy. Welch talked about the bills, which he will introduce with cosponsor Rep. Morgan Griffith (R-Va.), and the visit was featured in an article in the Rutland Herald. Welch discussed H.R. 803, which was introduced earlier this year and would ban retroactive pharmacy DIR fees, and a forthcoming bill which would prohibit PBMs from excluding independent pharmacies from joining preferred pharmacy networks for Medicare patients. Welch and Griffith are longtime community pharmacy champions. NCPA appreciates their continued support.
House Rules Committee to hold hearing
on Medicare for All legislation
The House Rules Committee will hold the first-ever congressional hearing on "Medicare for All" next Tuesday. The session will focus on the Medicare-for-All bill authored by Rep. Pramila Jayapal (D-Wash.), who has led progressives' efforts in the House to secure hearings and build support for the single-payer legislation. House Speaker Nancy Pelosi pledged in January to allow Medicare for All hearings in the rules and budget committees this year. But Democratic leaders have downplayed the prospect of bringing the controversial legislation to the floor, amid ideological splits within the caucus over the path forward on health care.
NCPA supports legislation
to expand access to OTC products
This week, the Health Choices Coalition, of which NCPA is a member, sent letters of support to the Senate and House cosponsors of S. 1089 / H.R. 1922., which would allow consumers to purchase over-the-counter medications with an FSA or HSA without a prescription. In letters to the Senate and House cosponsors, the organizations voiced full support for the legislation noting “Consumers depend on OTC medicines as a first-line option for meeting their families’ healthcare needs. OTC medicines provide Americans with effective, affordable, convenient and accessible means to alleviate the symptoms of minor to moderate ailments.” The letter continued “Prohibiting the use of HSA/FSA funds to purchase these medicines or requiring documentation from a doctor that OTCs are being used to treat a medical condition, limits access and reduces the cost-efficiencies associated with these medicines.” NCPA will continue to monitor and support the effort to reduce barriers to consumers using their HSA or FSA funds to purchase effective OTC treatments.
Invite your legislator for a visit during
the Memorial Day in-district work period
The next in-district work period for Members of Congress is scheduled to coincide with the Memorial Day, May 25- June 2. It is not too early to extend an invitation to your legislator to visit your pharmacy during this week or to schedule a group meeting with multiple community pharmacists with legislators and discuss priority issues. These carry extra value if your legislator is new to Congress so you can familiarize them with community pharmacy and our issues or if they are a member of the Energy and Commerce or Ways and Means health subcommittees, the starting points for much of community pharmacy’s legislation in the House.
Pharmacy visits and face-to-face meetings are tremendously effective ways to communicate with legislators and to establish yourself as a resource to them as issues arise. Visit NCPA’s pharmacy visits webpage or contact Michael Rule at michael.rule@ncpanet.org for tips on arranging a visit with your legislator.
Important track-and-trace changes are coming
Additional requirements for trading partners under the Drug Supply Chain Security Act (also known as the "track-and-trace law") are coming. After Nov. 27, 2019, wholesalers can only accept pharmaceutical products that have a DSCSA-compliant product identifier, subject to exceptions listed in FDA guidance regarding grandfathered product. Further, after this date wholesalers will be required to verify with the manufacturer of a product the DSCSA-compliant product identifier if that product is being submitted as a saleable return. It is important for community pharmacists to know this date because the changes may impact saleable returns and inventory management at the pharmacy level. But the changes don't stop there. After Nov. 27, 2020, pharmacies can also only accept pharmaceutical products that have a DSCSA-compliant product identifier, subject to the FDA guidance on grandfathered product. NCPA recommends that pharmacy owners immediately ask their trading partners how these compliance dates may impact your pharmacy and plan accordingly.
Click here for a poster on track-and-trace requirements and here for more information from the FDA.
Rep. Dave Loebsack to retire from Congress in 2020
Rep. Dave Loebsack (D-IA), one of community pharmacies’ greatest allies on Capitol Hill, announced he will retire in 2020. Rep. Loebsack has represented Iowa’s 2nd Congressional District since 2006. We are grateful to Rep. Loebsack for his staunch support of issues that help both patients and community pharmacies.
State roundup
Oklahoma SB 841, which contains important protections for patients and pharmacies, has passed both chambers of the Oklahoma State Legislature. The bill protects patient access to pharmacy services by establishing network adequacy and “any willing pharmacy” requirements, minimizes PBM conflicts of interest by prohibiting higher reimbursement rates for PBM-owned pharmacies, and limits PBM abuses by prohibiting retroactive claim adjustments and denials. The bill also ensures that all manufacturer rebates and compensation received by PBMs are used to benefit patients in the form of lower premiums and out-of-pocket expenses.
The U.S. Supreme Court has asked the U.S. solicitor general to weigh-in on whether the justices should review a ruling by the 8th Circuit Court of Appeals which struck down an Arkansas law that regulated PBMs.
NCPA submitted comments on proposed revisions to compounding regulations in North Dakota and Ohio this week.
NCPA state legislative activity update
Click the links to view a report of bills that have been introduced so far this session specifically dealing with NCPA’s top three state priorities: Medicaid managed care payment reform, scope of practice and compensation for services, and PBM reform and regulation. You can access the individual bill language and basic information on the bill by clicking on the bill numbers in the reports.
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.