Pharmacy leaders press their case as health-reform debate intensifies

WASHINGTON —With the debate over health reform heating up on Capitol Hill, more than a dozen influential chain pharmacy leaders pressed their case for pharmacy-friendly legislation in a rapid-fire series of direct meetings with members of Congress Sept. 22. Behind the coordinated lobbying effort: the growing urgency of the health-reform movement and its potential impact on their business.

All those participating in the intensive lobbying thrust were members of the National Association of Chain Drug Stores board of directors. Their top priority: convincing lawmakers that community pharmacy plays a key role in reducing healthcare costs, improving quality care and increasing access to vital pharmacy services.

“We are pleased that many of our board members could be in Washington,” noted NACDS president and CEO Steve Anderson. “Consistent with the NACDS Principles of Healthcare Reform, we have advocated provisions that are essential for cost-effective and high-quality patient care.”

NACDS staffers expressed satisfaction at the tenor of the meetings, with one describing lawmakers as receptive to pharmacy’s concerns. The lobbying effort came amid accelerating efforts by Congress and the White House to reach agreement on a sweeping overhaul of the health system, including finding ways to expand health coverage to all Americans, shifting the health focus to prevention of diseases that generate high-cost treatments and involving all health stakeholders in an urgent campaign to curb fast-rising health costs.

Pharmacy leaders want to assure a strong position for the industry within the new health system that could arise from the massive transformation effort.

“The timing couldn’t be more critical as the Senate Finance Committee deliberates on healthcare reform,” Anderson noted. “NACDS continues to urge lawmakers to include pro-patient, pro-pharmacy policies in those deliberations.”

On the Hill, NACDS and its board members urged lawmakers to include pharmacist-delivered medication therapy management provisions in any health legislation package. “MTM can help improve patient care and health outcomes through medication adherence and counseling, preventing more costly forms of care over the long term,” the group noted in a statement.

NACDS directors also pressed members of the House and Senate to correct the flawed Medicaid pharmacy reimbursement system. “Under current law and subsequent rules by the Centers for Medicare and Medicaid Services, the Government Accountability Office estimates that pharmacies would be paid 36% below cost for many generic drugs dispensed to Medicaid patients,” NACDS stated.

Those cuts, which have yet to take effect, were ushered in four years ago with passage of the Deficit Reduction Act, which mandated that the average manufacturer price of a multiple-source drug would henceforth serve as the benchmark for payment to pharmacies for generic drugs dispensed under Medicaid. “The law would result in cuts of $8.5 billion for Medicaid reimbursements to pharmacies over five years—a 30% cut,” Anderson noted.

Those cuts still are on hold, thanks both to a temporary moratorium set forth by Congress in the 2008 Fair Medicaid Drug Payment Act and a preliminary injunction that resulted from a lawsuit filed by NACDS and the National Community Pharmacists Association. Although the moratorium expired on Sept. 30, the court-ordered injunction remains in place for an indefinite period while CMS works to comply with a court order to redefine its definition of a multiple-source drug for purposes of pharmacy reimbursrement.

The temporary reprieve, however, was little comfort to the pharmacy leaders lobbying on Capitol Hill. “Pharmacy advocates are urging lawmakers to permanently fix this system,” NACDS noted. “Otherwise, these cuts could do damage to healthcare access for millions of disadvantaged Americans. Further, these cuts could mean insufficient pay and job loss, pharmacy closures and reduced access to cost-saving generics.”

Anderson said his group was encouraged that provisions related to three specific pharmacy topics are included in bills currently under consideration in Congress. Those provisions include enhancement of community pharmacist-provided MTM, which helps patients take the right medications correctly; reform of the Medicaid pharmacy reimbursement system to help maintain patient access to community pharmacy services; and ensuring patient access to durable medical equipment, such as diabetic testing supplies, through community pharmacies.

“Pharmacies are essential to healthcare delivery every day, and the current H1N1 situation is yet another example of just how true that is,” Anderson said. “Pharmacies are integral to the national H1N1 vaccination strategy, and this demonstrates that the accessibility of pharmacy should be tapped and not jeopardized through damaging policies.”