NCPA Advocacy Update

Week ending July 12

Author: APCI Staff/Tuesday, July 16, 2019/Categories: Legislative Affairs

204 stakeholders urge Senate Finance Committee
to address pharmacy DIR fees

This week, NCPA along with 203 other pharmacy and patient stakeholders sent a letter to Sens. Charles Grassley (R-Iowa), Chairman of the Senate Finance Committee, and Ron Wyden (D-Ore.), Ranking Member of the Finance Committee, urging them to address pharmacy DIR fees in potential legislation addressing drug pricing. The signatories noted, “If CMS will not act then Congress must. For these reasons, we continue to urge the Senate Finance Committee, with your leadership, to deliver seniors real relief from rising prescription drug costs. We stand ready to work with you to determine how we can adopt this much-needed and overdue reform relief this year.”

Grassley and Wyden are working to reach an agreement on a bipartisan legislative package to address high drug costs, which could be considered by the Committee as soon as July 17.

Regardless of whether your Senator is a member of the Finance Committee, continue to email your senators and encourage them to voice their support for such action and ensure it is included in the final legislative package.


Trump administration withdraws
proposed rebate rule

This week, the Trump administration decided to scrap its proposal to end the safe harbor protections for rebates paid by manufacturers to PBMs. It had been touted as one of President Trump’s most ambitious proposals to lower drug prices and increase transparency but – particularly after the administration had already abandoned its separate proposal to fix pharmacy DIR fees – NCPA had reservations about how this rebate proposal would have been implemented. In fact, in our comments on the proposed rebate rule, we emphasized the need for pharmacy DIR fee reform to prevent PBMs from utilizing other forms of remuneration to make up for loss of revenue on the rebates. We also shared our concern that the proposed rule didn’t sufficiently consider the impact it would have on small business community pharmacies.

Earlier this week, NCPA government affairs staff met with the White House Office of Information and Regulatory Affairs (OIRA) regarding this rule. The meeting focused on the need to address pharmacy DIR in addition to manufacturer rebates and concern that the proposed rule did not appropriately analyze how the policy change would impact small business community pharmacies.


Energy and Commerce Health Subcommittee
advances bipartisan health bills

This week, he House Energy and Commerce Subcommittee on Health advanced several bipartisan health bills, including H.R. 2296, the FAIR Drug Pricing Act sponsored by Rep. Jan Schakowsky (D-Ill.) which requires manufacturers to report drug price increases. Rep. Buddy Carter (R-Ga.) also offered an amendment to add other bipartisan drug pricing provisions to this bill as a package, which included two NCPA endorsed bills; H.R. 2155, the Public Disclosure of Drug Discounts Act and H.R. 2376.

H.R. 2155, introduced by Reps. Abby Spanberger (D-Va.), Jodey Arrington (R-Texas), and Brendan Boyle (D-Pa.) would require PBMs to disclose the aggregate amount of rebates, discounts, and price concessions that PBMs negotiate with drug manufacturers, and make this information publicly available. Rep. Carter’s amendment, which was supported by full committee Chairman Frank Pallone (D-N.J.) and Ranking Member Greg Walden (R-Ore.), would also require PBMs to disclose pharmacy DIR fees.

H.R. 2376, introduced by Reps. Jerry Nadler (D-N.Y.), Chairman of the House Judiciary Committee and Doug Collins (R-Ga.), Ranking Member of the House Judiciary Committee, would require the Federal Trade Commission to conduct a study on the state of competition in the drug supply chain. This study would focus on whether PBMs have engaged in any anti-competitive practices, such as steering patients to pharmacies for anti-competitive purposes, giving such pharmacies more favorable rates than it offers to competing pharmacies, or using its market power to depress the use of lower-cost prescription drugs. The bill also requires that the FTC provide policy recommendations for how to improve transparency and competition in the pharmaceutical supply chain.

This new drug pricing package could be marked up by the full Energy and Commerce Committee as early as next week. NCPA thanks Chairman Pallone and Ranking Member Walden, as well as Rep. Carter, for their leadership and looks forward to working with the committee to advance this legislation.


Keep your legislators busy
during the upcoming August recess

Congress will adjourn for its August recess on July 27 and is not expected to return to Washington until September 9. Many legislators will be looking for opportunities to connect with constituents, so why not invite them to visit your pharmacy or schedule a group meeting with multiple community pharmacists with legislators and discuss priority issues, such as the need for Congressional action to address pharmacy DIR fees. 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.


NCPA asks President Trump to support
increased drug pricing transparency

Last month, President Trump issued an Executive Order (“EO”) directing the Administration to take action to improve price and quality transparency in healthcare; however, it did not touch on prescription drug prices nor Pharmacy Benefit Managers’ (“PBM”) opaque business practices. Therefore, NCPA sent a letter to President Trump asking the Administration to support Congressional efforts to increase transparency and lower prescription drug prices for consumers. We reiterated that ending the retroactive nature of pharmacy price concessions is essential to efforts to improve price and quality transparency in the healthcare system. NCPA expressed that its membership is ready to work with the Administration to pursue reforms that will accomplish our shared goals.


NCPA Staff Presents Webinar
on the Drug Supply Chain Security Act

This week, Kala Shankle, Director of Policy and Regulatory Affairs, and Lisa Schwartz, Senior Director of Professional Affairs, presented a webinar on present and future implications of the Drug Supply Chain Security Act on community pharmacies. The webinar further discussed pharmacy practices and solutions to help community pharmacies comply with the law.


Federal Judge Vacates Final Rule
on Drug Pricing Transparency in Consumer Advertising

This week, Judge Amit P. Mehta of the U.S. District Court for the District of Columbia vacated a U.S. Department of Health and Human Services (HHS) final rule that would require the list prices of prescription drugs to be included in direct-to-consumer advertisements. Specifically, the Memorandum Opinion held that HHS exceeded its authority because Congress did not grant it the power to regulate drug marketing and the violated the First Amendment of the U.S. Constitution. NCPA has expressed concern over the policy in comments to the agency during the rulemaking period last fall. Notably, NCPA expressed concern that the publication of the list price in advertisements may deter patients from picking up their prescriptions at the pharmacy counter – a notable concern for medication adherence.


PBM Licensure Bill passes
New Hampshire legislature

This week, he New Hampshire General Court passed SB 226, a PBM licensure bill. The bill had previously passed the State Senate and will now be sent to Gov. Chris Sununu (R) for his signature.


NCPA state legislative activity update

NCPA tracks state legislation related to our top three state priorities: Medicaid reform, scope of practice and compensation for services, and PBM reform and regulation. Linked below are reports of bills that have been introduced so far this session specifically dealing with these three issue areas. You can access the individual bill language and basic information on the bill by clicking on the bill numbers in the attached report. Bills that have moved this week are listed at the top in the “Recently Updated” section.


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.

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