Table of Contents

• 2024 Special Compliance Allowance
• U.S. House Passes PBM Reform Bill
• Changes Coming to ‘True Up’ Dividend
• Health Mart Offers Collaborative Practice Agreement
• NCPA Preparing ‘DIR Hangover’ Survey
• APCI’s Reybold Promoted to VP
• Register Today for the 2024 APCI Convention!
• On the Shelf: Bee Clean Hand Sanitizer
• Happy New Year from APCI!

2024 Special Compliance Allowance

APCI members who maintain purchasing compliance and take part in the co-op’s Choice and PRO services can earn up to $4,000 in compliance allowances in 2024!

Eligible pharmacies will receive a $1,000 allowance each quarter in 2024. Eligibility is based on two factors: 1) a minimum generic purchasing ratio (GPR) of 90 percent for each month in the quarter; and, 2) participation in APCI’s Choice and PRO services for each month in the quarter.

“Incremental rebates are the easiest way to get the best cost of goods for our members, and maintaining a compliant GPR gets the greatest rebates,” said Susan Maze, APCI’s Chief Operating and Financial Officer. “Our Choice and PRO services help pharmacies maximize their operations and profitability. Putting these together with purchasing compliance is a no-brainer when it comes to making the most of your APCI membership.”

Maze added that the allowance is one way the co-op is working to assist members heading into what is expected to be a challenging year for independent pharmacies.

“With the DIR hangover starting in January, cash flow is going to be an issue for many of our members,” she said. “We know a pharmacy’s cost of goods is lowest when they maximize their rebates and take part in APCI programs. This allowance program is a way to support our pharmacies.”

For more information on the 2024 compliance allowance, contact your APCI Account Executive.

U.S. House Passes PBM Reform Bill

The U.S. House of Representatives passed a wide-ranging health care bill that includes significant aspects of pharmacy benefit manager reform. The bill will now go to the Senate for consideration.

HB 5378, the Lower Costs, More Transparency Act of 2023, would end the practice of “spread pricing” in Medicaid and features several other provisions to regulate PBMs. The bill passed the House by a 320-71 margin on Dec. 11. It is not yet known when the Senate will take up the legislation.

In addition to the spread pricing provision, other aspects of the bill related to pharmacy include:

• Requiring PBMs to provide group health plans with access to their data
• Establishing pass-through payment model
• Creating a Medicaid managed care “rate floor” like that of Medicaid fee-for-service that focuses on cost-based pharmacy reimbursement and dispensing fees
• Requiring PBMs to provide employers with semi-annual detailed data on prescription drug spending, including acquisition costs of drugs, total out-of-pocket spending, etc.

APCI issued a press release applauding the vote, with APCI CEO Tim Hamrick stating that the “bipartisan manner in which this bill passed the House shows that our legislators can work across the aisle to pass bills that will make a significant difference to the out-of-pocket prescription costs for patients across the country.”

More than 40 bills related to PBM reform have been proposed in Congress this year, but the Lower Costs, More Transparency Act of 2023 is the first piece of legislation to receive a vote before either the full House or Senate. Of the remaining bills, there are three pieces of legislation in the Senate that are of particular interest to APCI members. These include:

• S.2973 – The Modernizing & Ensuring PBM Accountability Act (MEPA): This bill would tackle PBM conflicts of interest and increase transparency in Medicare Part D by delinking PBM profits from higher drug prices as well as requiring PBM reporting of certain information.
• The Better Mental Health Care, Lower-Cost Drugs, and Extenders Act (BETTER): While it has not yet been assigned a bill number, this legislation would require PBMs to grant essential pharmacies in preferred network service areas (80% of independent pharmacies) access to networks and that total reimbursement for essential retail pharmacists not be less than NADAC. Effective dates would be 2028.
• S.1339 – The Pharmacy Benefit Manager Reform Act: This is a sweeping piece of bipartisan PBM legislation that contains significant transparency reporting requirements, bans spread pricing, requires rebates to be passed through to plan sponsors, and prohibits PBM clawbacks. There are issues with concerning a lack of language preserving states’ ability to regulate PBMs in the commercial and self-funded markets.

APCI will continue to track these bills as they make their way through Congress. For more information, contact the APCI Legislative Affairs Department.

Changes Coming to ‘True Up’ Dividend

Changes are coming to APCI’s annual true-up dividend in 2024.

The annual additional dividend payment, paid in the spring following the co-op’s financial audit, will now be paid only to members with a generic purchase ratio (GPR) greater than or equal to 90 percent. The monthly seven percent interim dividend payment will not change and will continue to be paid to all APCI stockholders based on APC1 generic purchase through McKesson OneStop.

The APCI Board of Directors voted at their December meeting to enact the change. A letter was sent to APCI Stockholders informing them of the decision during the first week of December.

“For the past year, APCI has been laser-focused on purchasing compliance, because when we have more members that are compliant, the cost of goods is better for all members,” said APCI CEO Tim Hamrick. “We strongly believe that compliance is in the best interest of every APCI member pharmacy, and this change to the true-up dividend is the most equitable way to distribute the co-op’s dividends.”

Specifically, true-up dividend eligibility will be determined by the following qualifications:

• The dividend will be based on APC1 generic purchases through McKesson OneStop.
• Only members with a Generic Purchase Ratio (GPR) equal to or greater than 90 percent will be eligible for the annual “true up” dividend paid each spring subsequent to the financial audit. This calculation will be based on each month’s GPR. For example, if the pharmacy had a GPR less than 90 percent for three months in the calendar year, the pharmacy would receive the “true up” for the nine months the GPR was equal to or greater than 90 percent.
• APCI will continue to pay the board approved monthly interim dividend of 7% for 2024 to all APCI members based on APC1 generic purchase through McKesson OneStop.

APCI is offering tools and information to non-compliant members to help maintain compliance ratios. For questions or more information on these changes or for assistance with purchasing compliance, please contact your APCI Account Executive.

Health Mart Offers Collaborative Practice Agreement

Health Mart is offering a Collaborative Practice Agreement (CPA) for APCI members who lost access to the PrescribeWellness CPA when APCI’s contract with PW ended on Nov. 30.

PrescribeWellness cancelled many members’ protocols if they did not respond to opt-in messaging during the changeover.

To ensure that APCI members are in legal compliance for providing immunizations, Health Mart offers a stand-alone Immunization CPA for $250 per year via PrescribeWelllness. You can click here to learn more about the HM Immunization CPA program and enroll by logging onto myHealthMart.com and navigating to Clinical > Immunizations > Become an Immunizing Pharmacy.

The Health Mart Retail Vaccine Program enrollment banners are also in the process of being updated to reflect changes in enrollment status as they are reported by PrescribeWellness. Most pharmacies were updated this past Friday, Dec. 15th.  Pharmacies who recently canceled or declined to re-enroll for PrescribeWellness services may still reflect as enrolled on the myHealthMart.com site until the vendor updates their report which typically happens the first week of each month. In the interim, if a pharmacy needs to enroll in the Health Mart Immunization CPA program but still reflects enrolled on myHealthMart.com site, they can click here.

For questions or more information, contact Health Mart at vaccineprograms@mckesson.com.

NCPA Preparing ‘DIR Hangover’ Survey

In addition to sharing information and holding webinars to help independent pharmacies prepare for the upcoming “DIR Hangover,” NCPA is preparing a special member survey to assess the state of the industry and take the pulse on this critical issue.

Anticipated reductions in prescription reimbursements at the point of sale, plus the DIR lag from 2023, plus the inflationary impact on the cost to dispense will challenge even the most seasoned pharmacists – and NCPA wants to track things to help keep independent pharmacies in the best possible financial position. Keep an eye on your inbox for this important survey.

In the meantime, NCPA has published a number of practical tips to help pharmacies avoid this potential pain point. Visit NCPA.org for frequent updates.

APCI’s Reybold Promoted to VP

APCI’s Greg Reybold was recently promoted as the co-op’s Vice President of Healthcare Policy and General Counsel.

The move was approved by APCI’s Board of Directors on December 5.

Reybold joined APCI in September 2021, and has been active in working with the APCI legislative team to develop healthcare policy at both the state and federal levels. He has also been managing the co-op’s legal affairs.

“Greg has been an amazing addition to the APCI team,” said APCI CEO Tim Hamrick. “His impact on the state and federal stages in his short time at APCI has been off the charts. Greg has developed a strong reputation in Washington and the states as a ‘go-to’ source for issues related to independent pharmacy and PBMs. No one works harder to fight PBM abuses, and the board recognized that work with this well-deserved promotion.”

Reybold is a veteran healthcare attorney, government affairs professional, and litigator with an expertise in combating abusive PBM practices through legislative and regulatory processes. During his tenure at APCI, Reybold has authored numerous comments to federal agencies on independent pharmacy issues, testified before the Federal Trade Commission, and has worked with numerous Congressional staffs on proposed legislation in addition to his legal work for the co-op.

Prior to joining APCI, Reybold served as General Counsel and Vice President of Public Policy for the Georgia Pharmacy Association (GPhA). He was previously a partner in the law firm Daley Koster, LLC. In private practice, Reybold maintained a governmental practice and healthcare practice with a strong emphasis on independent pharmacy. Reybold is a graduate of Emory University School of Law. He and his wife Melissa live in the Atlanta, Ga., area and have two sons, Jack and Max.

Register Today for the 2024 Annual Convention!

Registration for the 2024 APCI Annual Convention and Stockholders Meeting, March 21-24, 2024, at the Westin Harbor Golf Resort & Spa in Savannah, Ga. is open!

The 2024 convention is a special one, as APCI will celebrate the co-op's 40th anniversary in 2024! As such, our theme for the convention and the year is "Cheers to 40 Years: The Best is Yet to Come!"

As always, the 2024 edition will include informative and relevant continuing education courses, top-notch entertainment, preferred vendor promotions, and so much more!

Visit convention.apcinet.com to learn more and to register!

Bee Clean Hand Sanitizers

For patients looking for an alternative to harsh hand sanitizers, consider Bee Clean Hand Sanitizer!

Bee Clean contains organic ethyl alcohol to kill 99.9% of germs. It uses beeswax to coat the skin to lock in moisture, protecting from germs after it is applied. Beeswax also helps prevent dryness due to alcohol evaporation and cleans using natural antimicrobial peptides.

Bee Clean’s proprietary combination of beeswax, vitamin E, avocado oil, and apricot seed oil make hands feel soft with no sticky residue. Beeswax has emollient properties to soften dry, rough skin, and it promotes healthy cells, making skin look and feel better.

Bee Clean has been formulated with the goal of making the most natural and functional hand sanitizer possible. All ingredients (including the alcohol) are organically sourced and of the highest purity.

Bee Clean refreshes with peppermint and lemon or soothes with lavender essential oils for a light and revitalizing scent. Bee Clean is not heavy, medicinal, or overly perfumed like many other hand sanitizers.

Bee Clean has attractive packaging in an exciting unique shape that customers love. Its credit card size is easy to carry, and its spray application is simpler to use than liquids, gels, and pumps. (200 sprays per unit).

Bee Clean hand sanitizers are featured in the February sales circular and are available through McKesson.

Happy New Year!

APCI wishes you and yours a happy and prosperous 2024! As a reminder, APCI offices will be closed Monday, Jan. 1, 2024, so our employees can enjoy the holiday. We will reopen for regular business hours on Tuesday, Jan. 2.