By Michael Rule, Associate Director of Public Affairs and Grassroots Advocacy
This past Wednesday (July 24), Representative Doug Collins (R-GA) took to the House floor to speak on the benefits of independent community pharmacy. Rep. Collins noted his personal experience with independent community pharmacy stating that he frequents Woody’s Pharmacy in GA. Further, he highlighted his experience with proprietor Kevin Woody, “And I go in there and I know that when I ask him about the drugs for myself, for my wife, my kids, he gives me answers. He helps me know why they interact, what goes on. We’ve got pharmacists in all kinds of settings that do that every day for folks.”
For community pharmacists, it is not surprising that Rep. Collins would speak highly of his experience as patient testimonials are common. To help explain why he chose to address pharmacy issues, Rep. Collins noted that he is committed to speaking on and drawing attention to issues that may not be the prominent issue of the day, but nonetheless are extremely important to the American people.
Rep. Collins focused on three pharmacy issues: access to diabetes testing supplies (DTS) for Medicare Part B beneficiaries, fair pharmacy audits, and the need to level the playing field for independent pharmacies in negotiating PBM contracts.
First, on diabetes testing supplies, Rep. Collins noted that in rural Georgia an independent pharmacy may be the only option available to seniors. For this group, their local pharmacist helps them properly use their test strips and meters and provides guidance in managing their disease. Yet, pharmacies saw their reimbursements for DTS cut 72%. These cuts have led to consumer complaints that their product of choice was unavailable, they have had to switch providers, costs have increased or communications from CMS has been poor. As a result, Rep. Collins called on Congress to address the DTS issue as it is forcing pharmacies to decide between staying open and providing necessary patient supplies.
Rep. Collins then focused his attention on pharmacy benefit managers (PBMs) and some of their abusive practices. He rightly noted that PBMs are one of the most unregulated segments of the healthcare market, and that their practices are often anti-competitive and anti-consumer. He also offered solutions to these problems. He mentioned he is a co-sponsor of H.R. 1188, the Preserving Our Hometown Independent Pharmacies Act of 2013. This legislation would grant a limited antitrust exemption to independent pharmacies and allow them to collectively negotiate contracts under certain circumstances. He further noted that granting this exemption is consistent with past exemptions granted by Congress.
Finally, he discussed abusive pharmacy audits. While he supports audits that focus on uncovering actual fraud and abuse, he highlighted evidence that shows PBM audits are often used as a profit line for the PBMs. He noted that PBMs often single out high cost drugs for the audit list, while ignoring generics, and use minor clerical errors to justify full recoupment of the drug cost. In fact, to quote Rep. Collins:
“Now, I’ve said before, there are a lot of things that make me scratch my head. This is one of them. It’s one thing to come in and be audited, it’s one thing to find a mistake in which there’s a clerical error—and there needs to be some correction to that clerical error. But let me go back, Mr. Speaker, and remind you that it was dispensed properly in the correct amount with the correct drug and the correct facility with the correct directions on there. But, however, on the paperwork on how the call came in, how they took the prescription down, they were audited and dinged for that, and they were not just dinged for the amount of their copay or their profit even; they were dinged for the entire amount of the drug.”
When Rep. Collins had finished his remarks, he was joined by Rep. Tom Marino (R-PA), the primary sponsor of H.R. 1188, who reinforced the importance of independent community pharmacies in communities across the country:
“They are the neighborhood staples that you have come to rely on. They are where you can go for basic medical advice, and they are where new parents can have their children’s prescriptions filled. On average, independent pharmacies fill over 200 prescriptions every day, provide immunization, durable medical equipment, diabetes training, and other vital services. Unfortunately, these independent pharmacies are more vulnerable than ever and are having to lay off workers at an alarming rate. As more independent pharmacies are forced to close their doors, I am increasingly concerned about the impact that this will have on American families, especially on those in rural areas like my district in northeast Pennsylvania.”
NCPA is grateful for Rep. Collins and Rep. Marino for speaking out on these issues and drawing attention to them. While these may not be the most talked about issues of the day, they are of great importance to not only small business independent pharmacies and the patients who rely on them, but also to communities as a whole.
Click here to view the entire half-hour discussion.