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Anderson urges renewed grassroots bid to shape health reform, slay DRA ‘dragon’


BOSTON —Determined lobbying and grassroots efforts by the National Association of Chain Drug Stores, and chain and independent pharmacy leaders nationwide, have enabled retail pharmacy to wrest a hard-won place at the table in the debate over healthcare reform. But progress made thus far “is not enough” to permanently head off such threats to the industry as Medicaid pharmacy reimbursement cuts, NACDS president and CEO Steve Anderson told pharmacy leaders last month.

Addressing the second business session of the 2009 NACDS Pharmacy and Technology Conference, Anderson issued another urgent call to chain pharmacy leaders to get more involved in the debate over the future of the U.S. healthcare system. “Please join us,” he admonished NACDS members. “We have no choice but to embrace our role as true reformers. Whatever the outcome of any specific legislation, our objective will remain the same,” Anderson added. “Just as we have over the past two years, we will utilize every legislative, regulatory, legal and media strategy in the pursuit of good policy. For pharmacy and the patients they serve, this battle will continue for a long, long time.”

NACDS, added its president, has remade itself over the past two years to become a more effective advocate on behalf of pharmacy’s interests in the policy-making arena. Those reforms were undertaken in response both to the ongoing health reform debate and to the Deficit Reduction Act of 2005, which “remains a major catastrophe for pharmacy,” in large part because it put into law a disastrous plan to dramatically cut Medicaid pharmacy reimbursements based on a new “average manufacturer price” pricing formula.

Indeed, Anderson said, one of the industry’s most critical priorities is to permanently fix the DRA’s Medicaid pharmacy reimbursement cuts under the AMP model, which he said will slash pharmacy payments to below-cost levels for many of the generic drugs they dispense to Medicaid beneficiaries.

“The regulations to implement these cuts have been written. But they remain blocked by two mammoth victories: a legislative delay secured last year…and a court injunction, which was secured through a lawsuit by NACDS and [the National Community Pharmacists Association]. Every day these cuts are not in effect, $5.5 million in pharmacy cuts are prevented. Our objective remains the same: to bring about as many of our Principles of Healthcare Reform as possible,” Anderson stated.

Anderson cited three key issues of critical interest to pharmacy advocates in the health reform debate. “These include reforming Medicaid pharmacy reimbursement, expanding the availability of medication therapy management…and exempting pharmacies that sell durable medical equipment…from the redundant and access-threatening requirements of accreditation and surety bonds.”

It’s a testament to pharmacy’s growing influence in the policy debate, Anderson said, that all three provisions are in the various versions of health reform legislation.

NACDS’ leader also recapped the organization’s advocacy efforts over the past two years, beginning with a letter to The Washington Post in November 2007 that opened its campaign “to promote pharmacies as the face of neighborhood health care.” Among the highlights: a cross-organizational event with 12 pharmacy organizations at the National Press Club, testimony before several congressional panels and a Capitol Hill briefing on MTM co-hosted by NACDS, the NCPA and the Iowa Pharmacy Association.

“There are many other signs that our internal reforms have led to enhanced branding of pharmacy’s role in healthcare delivery,” Anderson said. “For example, NACDS members were invited this year to participate in each of the regional White House forums on healthcare reform.”

NACDS staffers also have been actively engaged in health reform hearings held by the Senate Finance Committee and the Senate Health, Education, Labor and Pensions Committee, Anderson added. One culmination of those efforts has been the first annual RxImpact Day on Capitol Hill, when pharmacies across the United States responded to the organization’s call to flood the halls of Congress with “white coats” and bring pharmacy’s message to lawmakers and their staffs.

“On that day in June, more than 150 pharmacy advocates from 30 states met with more than 180 congressional offices, and with senior staff at the Department of Health and Human Services,” Anderson proudly recalled. “We made a huge splash for pharmacy. CNN took notice, interviewing Mary Sammons of Rite Aid, and filming pharmacists in the halls. And we secured some key commitments,” he continued. RxImpact Day, Anderson promised, “will be a cornerstone of NACDS’ advocacy forever.”

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