As President Barack Obama and congressional leaders get ready for a face-off between Democrats and Republicans at Thursday's health care summit, retail pharmacy groups reiterated their priorities in the national debate on reform.


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Retail Rx speaks up on eve of Obama health summit

February 24th, 2010

WASHINGTON – As President Barack Obama and congressional leaders get ready for a face-off between Democrats and Republicans at Thursday's health care summit, retail pharmacy groups reiterated their priorities in the national debate on reform.

This week Obama set the stage for the televised White House event when he unveiled his latest health care reform proposal. The administration said the measure bridges the gap between the House and Senate bills and includes new provisions to reduce waste, fraud and abuse.

According to the White House, the proposal reflects policies from the House-passed bill along with the president’s priorities and some changes to the Patient Protection and Affordable Care Act, the Senate-passed health insurance reform bill.

Key changes include eliminating the Nebraska Federal Medical Assistance Percentage (FMAP) provision and providing additional federal financing to all states for the expansion of Medicaid; closing the Medicare prescription drug "doughnut hole" coverage gap; bolstering the Senate bill's provisions that make insurance more affordable for individuals and families; fortifying the provisions to fight fraud, waste and abuse in Medicare and Medicaid; increasing the threshold for the excise tax on the most expensive health plans (the so-called "Cadillac" health plans); and improving insurance protections for consumers and creating a new Health Insurance Rate Authority.

Among Obama's priorities in the proposal are a middle-class tax cut for health care;  premium reductions aimed at helping over 31 million Americans lacking health insurance get coverage; a new competitive health insurance market to promote choice in coverage plans; a crackdown on insurance industry abuses and denial of care; and efforts to end discrimination against those with pre-existing conditions.

The National Association of Chain Drug Stores and National Community Pharmacists Association responded to Obama's new health reform proposal by emphasizing pharmacy's role in providing convenient, affordable access to health care — notably in helping patients take their medications properly — in turn improving health outcomes and preventing higher long-term costs.

"As leaders from both parties meet at the White House to discuss health care reform, it is an opportune time for pharmacy to once again stress its priorities and positions, which hold bipartisan support," NACDS president and chief executive officer Steve Anderson said in a statement. "There is broad support for improving lives through prevention and chronic disease management and for reducing overall health care costs, and that is what happens when community pharmacies help patients take the right medications in the right ways."

Anderson made his remarks as NACDS released a position paper that highlights its mantra of pharmacies as the face of neighborhood health care.

In a statement released earlier this week, NCPA executive vice president and CEO Bruce Roberts said the president's latest proposal "includes a number of provisions that benefit patients and are supported by community pharmacists. Other provisions, such as employer mandates and anti-fraud measures, should be carefully structured so as not to produce unintended consequences that undermine local pharmacists' ability to meet pressing health care needs."

He said NCPA also commends the president for the provision to close the Medicare prescription doughnut hole and his proposal's ban on "pay-for-delay" settlements that delay the introduction of lower-cost generic drugs.

"Pharmacists support reasonable efforts to effectively fight waste, fraud and abuse in Medicare and Medicaid," Roberts added. "But government officials should take care to avoid inadvertently restricting patients' access to legitimate health services as they pursue initiatives such as Medicaid Prescription Drug Profiling. The problematic pharmacy accreditation requirement in Medicare's durable medical equipment program is a prime example."

Roberts also noted that Obama's latest proposal is being offered as an addition to the Senate health reform package. "That bill includes a number of policies that community pharmacists support," he explained. "Namely, an equitable fix to Medicaid's average manufacturer price (AMP) reimbursement formula for generic drugs; an exemption for most community pharmacies from Medicare's onerous, costly accreditation requirements for sales of diabetes testing supplies and related goods; limited disclosure requirements for pharmacy benefit managers; and an expansion of medication therapy management (MTM) programs."

The NACDS paper stresses the need to improve medication adherence to improve health outcomes and lower long-term health expenses, noting that drug store chains can play a pivotal role through pharmacist-led MTM programs. It also noted that promoting the use of generics is key to helping rein in expenses on prescription drugs.

"Any successful health care reform effort must include strong steps to improve patient adherence to medication, particularly for those with chronic disease," the NACDS paper stated. "Both House and Senate health care reform legislation include a series of grant programs and other initiatives to improve medication adherence through MTM in the treatment of chronic disease, as well as grants to establish community health teams to support a medical home."

NACDS, too, emphasized the need to preserve patient access to pharmacy products and services. To that end, the association said in the paper that government officials and lawmakers must address lingering issues on pharmacy reimbursement for Medicaid prescriptions, including the definition of AMP and setting of federal upper limits (FULs).

"Community pharmacies and pharmacists have a unique role in a reformed health care system," the NACDS paper concludes. " Working directly with their patients to take their medications as prescribed, local pharmacists can improve quality of care and optimize medication use. We stand ready to work with Congress and the administration to ensure that Americans have access to affordable, high-quality care in a reformed health care delivery system."

*Editor's Note: Article updated with statement from NACDS' Steve Anderson and link to position paper.

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