Pressing Phamacy Issues Covered In Opinion Pages

By John Norton

(NOTE: To read all NCPA opinion pieces go to the following link.)

As the health care reform efforts kicks into overdrive, NCPA recently had three opinion pieces published advocating for patients and community pharmacies on three major issues: mandatory mail order; durable medical equipment (DME) accreditation; and Medicaid’s Average Manufacturer Price (AMP) based cuts.

On Dec. 12, The Fort Worth Star-Telegram ran NCPA President Joe Harmison’s op-ed, Mandatory mail order jeopardizes pharmacy patients. This push at the federal, state, city and plan level must be nipped in the bud for a variety of reasons. Here’s an excerpt:

“Almost everything in medicine has changed since scribes in the Middle Ages recorded the work of those first pharmacists.

“Most changes have been good. We are grateful that the practice of using leeches has ended. Yet, there are also practices many of us miss, like physician house calls.

“One constant is the presence of a neighborhood pharmacist in almost every town, village and city. Time has not erased the need for highly trained medication experts to whom patients can turn for advice on the dosage, side effects, interactions and cost of medicines.

“There is an effort afoot to make this relationship as obsolete as the house call.

“Those who would benefit financially from requiring patients to order their drugs by mail are pushing this effort — giant pharmacy-benefit managers, or PBMs, such as CVS Caremark, Medco Health Solutions and Express Scripts, which collectively reported a 20 percent profit increase last year alone. They seek even greater profits on the backs of patients and community pharmacies by mandating the use of their own mail-order pharmacies.”

On Dec. 15, The Hill ran NCPA Executive Vice President and CEO Bruce Roberts’ op-ed, Unhappy New Year: Without congressional action, seniors could lose access to medical supplies. The Congressional extension for DME accreditation ends at the end of the month, so we are seeking a three month extension. Here’s an excerpt:

“On December 31st people reflect on the concluding year and look forward to the next year. For many seniors this day will also mark the end to a key aspect of their health care. Up until that point seniors can get their prescription drugs and medical supplies at their community pharmacy. It’s convenient and provides patients with access to pharmacists who are trained to maximize health outcomes. Come January 1st the second half of that consumer benefit could end.

“For seniors trying to obtain essential medical supplies like diabetes testing strips, canes and walkers the following scenario could occur across the country: the pharmacist will glumly explain, “I apologize, but due to a ridiculous federal regulation I am no longer able to sell those supplies to you.” For seniors, especially in underserved rural and urban areas, this unwanted development could possibly compromise their health.”

On Dec 17, Roll Call ran the Bruce Roberts op-ed, The Right Prescription for Medicaid. With a Senate-House reconciliation process in the offing once the Senate passes their health care reform bill, the issue of the different levels for Medicaid generic prescription drug reimbursement needs to be resolved. Here’s an excerpt:

“The solutions would restore significant portions of the cuts that the policy calls for and it certainly is helpful that larger, moving legislation has been used as a vehicle to address the concern. NCPA has estimated the House passed bill, which sets reimbursement limits at 130 percent of the weighted average AMP, costing retail pharmacies $18 billion over 10 years. The Senate bill still under consideration sets reimbursement at least 175 percent of weighted AMP, costing pharmacies $11.5 billion over 10 years. So while neither level is a panacea for the problem, the Senate alternative is what we prefer and hope the number increases as the process moves forward.

“Ultimately, reasonable Medicaid generic reimbursement is not about the financial well-being of pharmacies; but about the well-being of patients. If “Medicaid can make it possible for you to get the care that you need so you can get healthy—and stay healthy,” then don’t make the continued participation of retail pharmacies in the program financially untenable. Congress got us into this mess, now they need to get us out of it”.

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