By John Norton
The National Community Pharmacists Association’s (NCPA) advocacy efforts are predicated on having government play a more active role in fostering a marketplace that allows all businesses to compete on a level playing field. As a result of their sheer size, big businesses will always have some natural, built-in advantages. But when the regulatory environment also favors these giant corporations, small businesses like independent community pharmacies have an uphill climb to remain financially viable.
In response, NCPA and its members make compelling arguments on many issues, including more accountability and transparency for pharmacy benefit managers (PBMs). However, winning over supporters often requires unbiased, third-party validation. When the media devote resources to discerning the truth about a contentious issue, the ensuing news article or segment can further substantiate your call for action.
The bane of many independent community pharmacies’ existence is outdated, low pharmacy reimbursements for generic prescription drugs that do not match rising acquisition costs. NCPA has a growing online hub of information on this issue that can be found at http://www.ncpanet.org/advocacy/pharmacyaccess.
To that list you might want to consider adding an ABC News Nightline piece and accompanying article entitled “With Generic Prescription Drug Prices Surging, Families Are Feeling the Squeeze” from May 28.
The story begins by explaining how impactful these price spikes are to the most important stakeholder in our health care delivery system – patients. Tricia Salese learns from her local pharmacy that the price for Actiq, a generic prescription drug for pain relief, has gone up yet again. She says in five years the cost per dose has gone from 50 cents to $37.49. The financial walls are clearly closing in on Salese, as she explains:
“I realized if I wanted to keep my job and my life, I was going to have to find a way to pay for this,” she said. “I started taking money out of my IRA, and that’s how we had to pay for it.”
NCPA was contacted by ABC News to get pharmacy’s opinion. A section of the online story is dedicated to the insights and perspective of independent community pharmacists:
“A survey released last month by The National Community Pharmacists showed that 80 percent of pharmacists saw an upswing in generic drug prices 26 or more times over the previous six months. And 93 percent said the situation has grown worse since 2013.
“Brad Arthur, the president elect of NCPA, said the price spikes are unprecedented.
“‘Every month that goes by … we see a half a dozen added to that list,'” Arthur said. “‘And pharmacists’ hands are tied even as they are trying to help customers fill prescriptions below cost.'”
The piece goes on to make several additional important points:
- The price spikes are closing the previously wide price gap between brand name and generic drugs that was fueled by patents expiring—an unfortunate development for reining in health costs.
- There is a lack of transparency as to why certain generics drugs are going up.
- Sen. Bernie Sanders (I-Vt.), who held a hearing on this issue last year at which NCPA member and pharmacy owner Rob Frankil testified, and Rep. Elijah Cummings (D-Md.) continue to push for solutions.
- Two federal agencies (the U.S. Department of Justice and the U.S. Department of Health and Human Services) are investigating the prices spikes.
From the vantage point of independent community pharmacists our main focus continues to be on passing H.R. 244, the MAC Transparency Act, in the U.S. House of Representatives, and getting a companion bill introduced and passed in the U.S. Senate so that it can be signed into law. The federal legislative approach consist of:
- Preserving patient access to pharmacies by ensuring pharmacy reimbursement from PBMs are updated more frequently to keep pace with actual market costs; and
- Allowing pharmacies to know how its individual maximum allowable cost (MAC) reimbursement rates for multisource generic drugs are determined.
Feel free to use the ABC News story to further your arguments when you press lawmakers for their support.