Reps. Welch and Griffith Reintroduce
Any Willing Pharmacy Legislation
This week, Reps. Peter Welch (D-Vt.) and Morgan Griffith (R-Va.) reintroduced legislation that would ensure seniors have more convenient access to discounted or “preferred” copays for prescription drugs at their pharmacy of choice. The Ensuring Seniors Access to Local Pharmacies Act (H.R. 4946) would allow seniors in medically underserved areas to access lower copays at any pharmacy willing to accept the Medicare Part D drug plan’s “preferred pharmacy” terms and conditions (i.e., pricing). Currently, independent community pharmacies are often left out of such arrangements, despite playing a large role in caring for medically underserved populations. The result is that seniors in rural communities often face either higher copays or trips of 20 miles or more to a “preferred” pharmacy. Additionally, it would require claims level reimbursement transparency so pharmacies have a clearer understanding of their reimbursement. Finally, it includes language to prevent PBMs from reimbursing their affiliated pharmacies more than they do other pharmacies and to ensure reimbursement covers acquisition and dispensing costs, helping to establish a level playing field among all pharmacies. Original cosponsors of the bill include Reps. Dave Loebsack (D-Iowa), Buddy Carter (R-Ga.), Vicente Gonzalez (D-Texas), Cathy McMorris Rodgers (R-Wash.), Cindy Axne (D-Iowa), Rick Allen (R-Ga.), Collin Peterson (D-Minn.), Rick Crawford (R-Ark.), Phil Roe (R-Tenn.), and Bruce Westerman (R-Ark.). NCPA endorsed the bipartisan legislation and thanks Reps Welch, Griffith, and the original cosponsors for their work to increase choice for patients and transparency into PBM tactics.
U.S. House Unanimously Passes Pair
of Prescription Drug Pricing Transparency Bills
This week, the House of Representatives unanimously passed two transparency bills that would require more disclosure of the discounts drug companies give to pharmacy benefit managers. The bills would shine a light on rebates and DIR fees and obtain more data on how PBMs may be contributing to higher drug prices.
- H.R. 1781, the Payment Commission Data Act, sponsored by Rep. Buddy Carter (R-Ga), would provide drug pricing and rebate data to the Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment and Access Commission (MACPAC). Access to this data would help the independent commissions provide better policy recommendations to Congress.
- H.R. 2115, the Public Disclosure of Drug Discounts Act, sponsored by Reps. Abigail 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. NCPA was the only national organization to endorse the bill. Additionally, when the bill was marked up by the Energy and Commerce Committee, Rep. Buddy Carter offered an amendment, which was supported by Chairman Frank Pallone (D-N.J.) and Ranking Member Greg Walden (R-Ore.), that would require PBMs to disclose pharmacy DIR fees. The committee also added language to H.R. 2115 to require Medicare Part D plans to implement an electronic, real-time benefit tool that is capable of integrating with a prescriber's electronic prescribing system or electronic health record. As originally drafted, NCPA had concerns that the language would not include a patient’s preferred pharmacy of choice and could lead to patient steering by PBMs to mail order or PBM-owned retail pharmacies. NCPA secured bipartisan support from Chairman Pallone and Ranking Member Walden for a provision to ensure patient pharmacy choice is respected and to prevent pharmacy steering. After passage of the legislation, NCPA was mentioned in Rep. Spanberger’s press release announcing passage of the bill with a quote from NCPA’s Senior Vice President of Government Affairs & Director of the Advocacy Center, Karry LaViolette. NCPA thanks all of the Representatives for their transparency efforts and looks forward to the legislation advancing in the Senate.
Rep. Buddy Carter Speaks at General Session
and Attends LTC Meeting During NCPA Convention
Rep. Buddy Carter (R-Ga.) spoke at the First General Session at the 2019 NCPA Annual Convention. Carter, the only pharmacist currently serving in Congress, addressed attendees about pharmacy priorities and his work in Congress. While at the Convention, Carter also took the time to speak at a joint meeting of NCPA’s Long-Term Care Division Advisory Council and the NCPA Long-Term Care Steering Committee where he discussed top priorities with our members related to long-term care pharmacy issues of concern such as appropriate coverage for medical at home services.
NCPA Releases 2019 NCPA Digest
Sponsored by Cardinal Health
This week at the NCPA Annual Convention, NCPA released the 2019 NCPA Digest, sponsored by Cardinal Health (login required). The Digest is the annual barometer for independent community pharmacy owners to quantifiably measure themselves against their peers and their competitors. The Digest provides a summary of selected financial and demographic information that illustrates the independent community pharmacy market and the valuable services these pharmacies deliver to their patients and is the most comprehensive report on independent community pharmacy available. This year's Digest also establishes the role of the steadily growing CPESN® USA network of clinically integrated pharmacies in efforts to change the pharmacy payment model.
Among the important statistics in this year's Digest:
- 91 percent of community pharmacies are offering some type of medication adherence program, aligning the interest of patients, payers, pharmacists, and plans.
- 79 percent offer medication synchronization services.
- 76 percent provide flu immunizations.
- 57 percent perform blood pressure monitoring.
- 53 percent furnish durable medical goods.
- 65 percent of all independent community pharmacy owners donated to at least five local organizations in 2018.
NCPA PAC Shows Support
for Congressman Buddy Carter
NCPA PAC hosted a breakfast for Congressman Buddy Carter (R-Ga.) in conjunction with NCPA’s Annual Convention this week. Nearly 100 NCPA members greeted Congressman Carter, the only pharmacist in Congress, for breakfast on Sunday and was proud to raise over $38,000 for Congressman Carter’s re-election campaign. Carter was spoke to many of the pressing issues facing community pharmacy on Capitol Hill and answered many questions and concerns raised by attendees. As a champion of Community Pharmacy issues in Congress, the NCPA PAC strives to support Congressman Carter and his colleagues who champion our priorities. We thank all of our members who came out to tangibly demonstrate our appreciation and support for the Congressman.
NCPA PAC Hosts Annual Reception at Convention
NCPA PAC hosted its annual fundraising reception at the NCPA Annual Convention and raised over $15,000.. NCPA PAC contributors were addressed by PAC Committee Chairman Steve Giroux, as well as by incoming NCPA President Brian Caswell. We thank all NCPA PAC contributors for their continued support. A strong PAC is essential to our advocacy efforts in Washington and across all 50 states, and it would not be possible without active members contributing. As the leading voice for community pharmacy it is vital that we have a strong presence on Capitol Hill, and your contributions to NCPA PAC are integral in allowing that to happen.
If you would like to learn more about NCPA PAC, including how to contribute to its growing success, please contact Lamar Gillespie (lamar.gillespie@ncpanet.org) or Eric Lundberg (eric.lundberg@ncpanet.org).
NCPA State Affairs Team Hosts CE Session
on Implementing Medicaid Policy Changes
This week NCPA’s state affairs team hosted a CE session at the NCPA Annual Convention. Panelists included Arkansas State Senator Jason Rapert (R), 46 Brooklyn analyst Eric Pachman, New York pharmacy owner Steve Moore, and NCPA’s Senior Vice President of Government Affairs Karry La Violette and the discussion centered on strategies to implement Medicaid policy changes. Attendees learned how to tell their stories and their patients’ stories to lawmakers and how to become better advocates for the pharmacy profession.
Congress’ Veterans’ Day Recess Starts Today
Congress will be away from Washington until November 12. If you have not done so, it’s not too late to extend an invitation to your legislator to visit your pharmacy or schedule a group meeting with multiple community pharmacists with legislators to 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.
With the issue of impeachment drawing most of the attention, pharmacy visits and face-to-face meetings are tremendously effective ways to communicate with legislators and remind them of the other important issues requiring Congressional action and to establish yourself as a resource to them. Visit NCPA’s pharmacy visits webpage or contact Michael Rule at michael.rule@ncpanet.org for tips on arranging a visit with your legislator.
USDA Releases Interim Rule
on Domestic Hemp Production
Earlier this week the U.S. Department of Agriculture (USDA) released an interim rule on domestic production of hemp and how the crop will be regulated in the United States. Under the interim rule, the USDA may approve hemp production plans that must include testing, licensing, and disposal requirements. The rule is a major step in the implementation of the 2018 farm bill, which statutorily defined hemp as cannabis if it has less the 0.3% concentration of THC. The interim rule will undergo public comment over the upcoming weeks and is set for sunset in 2 years.
FDA Reports on Drug Shortages
The U.S. Food and Drug Administration (FDA) inter-agency Drug Shortages Task Force released a report, Drug Shortages: Root Causes and Potential Solutions, that evaluates the root causes of drug shortages and recommends potential solutions. The report identifies the following root causes for drug shortages: (1) lack of incentives for manufacturers to produce less profitable drugs; (2) limited recognition for manufacturers with mature quality systems; and (3) regulatory challenges that make it difficult for the market to recover from a shortage. The report’s proposed solutions include: (1) recognizing the impact shortages have on patient care; (2) encouraging drug manufacturers to invest in quality; and (3) promoting sustainable contracting approaches. Further, the FDA recognizes that drug shortages may be contributing to the need for pharmacists to conduct costly and time-consuming searches to find the drugs in shortage. FDA also acknowledged concerns raised at the listening sessions it held last year, where NCPA participated. NCPA will continue to engage with the FDA and the inter-agency Drug Shortages Task Force to help discover the causes of and solutions for drug shortages.
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.