• President Trump Strikes Deals with Nine More Drugmakers, More to Come
• Lankford leads letter to HHS and CMS on MDPNP Implementation 
• Blackburn Presses CVS on Driving Up Health Care Costs in Letter
• House Advances Republican Health Proposal, No Further Health Care Votes Expected This Year
• NCPA’s Anne Cassity Recognized as One of the Most Influential Health Care Policy Experts in D.C.
• Pharmacy Coalition Urges Prompt Passage of PBM Reforms 
• GOP Doctors Caucus Endorses PBM Reform Act
• NCPA Meets with CMS Innovation Center Over Fair Payment for GLP-1 Drugs for Weight Loss Under Medicare and Medicaid 
• NCPA’s Ronna Hauser Attends PBM Contracting Summit as a Panelist
• Joint Economic Committee Holds Hearing on Realigning Healthcare Incentives 
• FDA Releases Two-part Podcast on HRT, Initiates Removal of Black Box Warnings for Menopausal HRT   

President Trump Strikes Deals with Nine More Drugmakers, More to Come

President Donald Trump (R) announced nine more deals with pharmaceutical companies on Friday, the latest effort to lower prices for some drugs in exchange for a three-year reprieve from threatened tariffs. The most recent deals now mean that 14 of the 17 manufacturers Trump targeted earlier this year have now come to the table with agreements to lower prices for Medicaid and sell discounted drugs directly to consumers who would pay out of pocket through TrumpRx, which is set to be launched in the new year. He also promised to meet with big insurance companies by early January to discuss lowering their prices. 

The deals with drugmakers also include agreements to launch new medicines for the same prices as abroad, under Trump’s Most Favored Nation pricing system. The nine companies include Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Genentech, Gilead Sciences, GSK, Merck, Novartis, and Sanofi. These agreements are similar to those already struck with Pfizer, AstraZeneca, EMD Serono, Eli Lilly, and Novo Nordisk. The three remaining companies that haven’t announced deals with the administration yet are AbbVie, Johnson & Johnson, and Regeneron, but those are expected soon after the holidays. NCPA will keep members informed on the practical implications of these agreements on independent pharmacies as more information becomes available. 

Most notably, Trump ended the press announcement with a promise to meet with the big, rich insurance companies, who he said make “far, far more money than they’re entitled to,” either in Florida next week or in Washington, D.C. in the first week in January to ensure they are willing to cut their prices by 50 to 70 percent. He said he wants the money to go “directly to the people,” and is hopeful the insurance companies will lower their prices, stating that they would otherwise have to be cut out of the system.

Sen. Lankford Leads Letter to HHS and CMS on MDPNP Implementation

On December 11, Sen. James Lankford (R-Okla.) sent a letter to HHS Secretary Robert Kennedy, Jr. and CMS Administrator Dr. Mehmet Oz with concerns regarding the implementation of the Medicare Drug Price Negotiation Program (MDPNP).  Sen. Lankford was joined by five of his colleagues on the Senate Finance Committee Sens. Thom Tillis (R-N.C.), Steve Daines (R-Mont.), Marsha Blackburn (R-Tenn.), Roger Marshall, M.D. (R-Kan.), and Bill Cassidy, M.D. (R-La.). The letter highlights the concerns a poorly functioning system could have on seniors attempting to access their prescriptions, the reports of missed deadlines, lack of responsiveness from CMS, and challenges that community pharmacies have faced in the lack of communication on reimbursements and enrollment. The letter also noted how vulnerable long-term care pharmacies will be under this new payment system and requested CMS to take proactive measures to address all of these concerns. You can view the press release with the letter here.  

Blackburn Presses CVS on Driving Up Health Care Costs in Letter

On Monday, Sen. Marsha Blackburn (R-Tenn.) sent CVS Health CEO David Joyner a letter pressing him on the company's history of fraud, regulatory violations, role in driving up health care expenses, and evasion of compliance with government requests. She notes that CVS is incredibly vertically integrated and that all their companies have profited because of government spending. U.S. government spending drove over 60 percent of CVS' revenue growth in 2022-2024 with more than $216 billion in direct revenues. The senator pointed out that in Tennessee, insurance rates are jumping 30-42 percent next year and that CVS Caremark, their PBM, uses their power to under-reimburse independent and community pharmacies while giving themselves preferential treatment. 

In her questions to Joyner, Blackburn highlighted that in Tennessee, a CVS audit showed the company flaunted state warnings, continued noncompliant practices of preferential treatment of their affiliate pharmacies, and made inaccurate disclosures in their MAC pricing lists in an attempt to drive independents out of business. We applaud the letter, which you can read here, and look forward to seeing CVS held accountable in their responses. 

House Advances Republican Health Proposal, No Further Health Care Votes Expected This Year

This week, the House of Representatives passed H.R. 6703, the Lower Health Care Premiums for All Americans Act, legislation sponsored by Rep. Miller-Meeks (R-Iowa) and representing health care proposals from the House Republican Leadership. The vote was 216 to 211, with 6 Members not voting. All House Democratic members voted no. Rep. Massie (R-Ky.) was the only Republican to vote no. This legislation did include measures on PBM transparency; however, it did not include comprehensive PBM reform. While this legislation has passed the House, it is not currently expected to be considered in the Senate, which previously failed to advance Democratic legislation to extend expiring enhanced ACA premium tax credits, as well as a Republican health reform alternative with provisions to enhance access to health savings accounts and other provisions. Further action is not expected in Congress prior to expiration of the enhanced ACA premium tax credits on December 31, 2025. Both chambers of Congress have committed to taking up health care issues again in 2026. NCPA will continue to provide updates as developments occur and work with Congress to include comprehensive PBM reform in any upcoming health care package. 

NCPA’s Anne Cassity Recognized as One of the Most Influential Health Care Policy Experts in D.C.

Congratulations to NCPA’s own Anne Cassity, senior vice president of government affairs, for being named one of Washington, D.C. most influential health care policy pros by Washingtonian magazine. The list, published last week, recognizes the work of 54 advocates working to address a diverse array of problems in the nation’s health care system.

Anne’s listing comes just after Washingtonian included her on its list of the 500 most influential policy people in D.C. in May; read about that here.

Pharmacy Coalition Urges Prompt Passage of PBM Reforms 

Late last week, NCPA joined the American Pharmacists Association, FMI-the Food Industry Association, National Association of Chain Drug Stores, National Association of Specialty Pharmacy, and National Grocers Association on a pharmacy coalition letter sent to House and Senate leadership that urges prompt passage of PBM reforms.

The signatories noted the appreciation for the groundwork that has been laid thus far, but emphasized that despite these earnest efforts, the failure to curb harmful PBM practices is no longer a crisis in the making — it now constitutes a crisis unaddressed.

Specifically, the signatories noted that PBM reform must contain the top priorities supported by pharmacy, payment reform in Medicaid managed care programs and requirements for reasonable and relevant contract terms in Medicare Part D.

GOP Doctors Caucus Endorses PBM Reform Act

The GOP Doctors Caucus, a group of medical doctors serving in Congress, endorsed the PBM Reform Act (H.R.4317) on Tuesday. The bill addresses NCPA legislative priorities that were in the original Continuing Resolution package from December 2024. Reps. Greg Murphy (R-N.C.) and John Joyce (R-Pa.), who co-chair the caucus, expressly called out PBMs in a statement as driving up the cost of lifesaving drugs.

"Reform is long overdue to rein in the abuse of PBMs, which prioritize profits over patients through shady practices such as pushing high-cost drugs, limiting consumer access, monopolizing the market, and reimbursing pharmacies at unacceptable rates. This legislation will make much-needed reforms to put patients first,” they said.

This legislation saves taxpayers $5 billion and reins in PBM abuses to pharmacies by eliminating spread pricing, requiring reasonable reimbursement in Medicaid managed care, requiring reasonable and relevant Medicare Part D contracts, and creating an avenue for pharmacies to report Part D Contract violations. This endorsement highlights that all providers understand that we need PBM reform now!

NCPA thanks Murphy, Joyce, and the entire caucus for endorsing this priority legislation introduced by Rep. Buddy Carter (R-Ga.) earlier this year. The endorsement highlights that providers serving in Congress understand the urgency of PBM reform!

To learn more about the PBM Reform Act, click here.

NCPA Meets with CMS Innovation Center Over Fair Payment for GLP-1 Drugs for Weight Loss Under Medicare and Medicaid

NCPA met recently with staff of the CMS Innovation Center to advocate for fair payment for independent pharmacies as they develop a model for Medicare and Medicaid coverage of weight loss drugs that would incorporate some of the lower prices for GLP-1 drugs announced by the White House on Nov. 6. We have advocated that the Innovation Center consider how the participation of independent community pharmacies in the dispensing of GLP-1 drugs for weight loss purposes can be enhanced. Many small pharmacies are not dispensing the weight loss versions of the GLP-1 drugs. 

The pharmacy reimbursement predicament for these weight loss drugs is the worst under Medicare. We suggested that any model includes a specific ingredient cost reimbursement that covers the cost of the drug and its unique handling and storage requirements, as well as a commensurate professional dispensing fee, consistent with those used by Medicaid fee-for-service programs. We offered data to support our recommendations. NCPA expects to hear what this model will look like and will report out as we learn more in the coming days. 

NCPA’s Ronna Hauser Attends PBM Contracting Summit as a Panelist

Ronna Hauser, PharmD, NCPA senior vice president of policy and pharmacy affairs, recently attended the Informa PBM Contracting Summit, where she presented as a panelist on "Regulatory Snapshot — State Mandates and Federal Enforcement," as well as "Redefining Network Adequacy — Balancing Access and Geography." Attendees included mid-market PBMs as well as wholesalers, pharmacies, and law firms, among others. Discussions involved PBM reform trends at both the state and federal levels as well as ways to create robust pharmacy networks. GLP-1s, disruptor PBMs, rebates, 340B, and Medicaid in 2026 were also discussed. 

Ronna was able to cover groundbreaking state-level PBM reforms, including reimbursement floor mandates that are explicitly allowed per the Rutledge v. PCMA Supreme Court decision. She was also able to share the pharmacydeserts.com website with attendees, a new open-source interactive map focused on pharmacy shortage areas. The project is a collaboration between USC and NCPA as part of our Pharmacy Access Initiative. 

Joint Economic Committee Holds Hearing on Realigning Healthcare Incentives

On Wednesday, December 17, Congress' Joint Economic Committee (JEC) held a hearing titled, "Stop Paying More for Less: Realigning Healthcare Incentives to Improve Outcomes and Reduce Costs." The JEC is distinct from other Congressional committees in that it includes members from both the House and the Senate and presides over informational hearings as well as generating annual economic reports, rather than originating legislation like other Congressional committees.

While the ACA did figure most prominently in the hearing, Rep. Nicole Malliotakis (R-N.Y.) pressed witnesses on pharmacy benefit managers' role in increasing healthcare costs while worsening outcomes.

NCPA submitted a  statement for the record for this hearing, urging the JEC to focus on the role of PBMs in increasing healthcare costs. You can watch the whole hearing here.

FDA Releases Two-part Podcast on HRT, Initiates Removal of Black Box Warnings for Menopausal HRT 

Food and Drug Administration Commissioner Marty Makary released a set of two episodes of the FDA Direct podcast to discuss the agency's actions on Hormone Replacement Therapy (HRT). The podcast episodes featured discussions with the physicians regarding their work on menopause and HRT. The commissioner and experts generally agreed that HRT offers important benefits and that physicians need more education regarding its use, with Makary criticizing in particular the medical community, the agency, and the media for actions that served to limit access to the treatment based on faulty analyses. 

The video for part one is available on X here, and part two is here. The part one transcript is available here, and the part two transcript is available here. 

Additionally, the FDA has initiated the removal of "black box" warnings from menopausal hormone replacement therapy products. Specifically, the agency is working with companies to update language in product labeling to remove references to risks of cardiovascular disease, breast cancer, and probable dementia. The FDA is not seeking to remove the boxed warning for endometrial cancer for systemic estrogen-alone products. 

Click here for a recent NCPA/Alliance for Pharmacy Compounding joint letter to the FDA on the benefits of menopause hormone therapy.

Due to the holidays, the NCPA Advocacy Center Update will resume on January 9.

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. The weekly update is intended exclusively for the recipient and is not for external distribution.