As President Barack Obama and congressional Democrats and Republicans square off over raising the debt ceiling, the National Association of Chain Drug Stores aims to ensure that patient access to pharmacy services isn't curtailed.


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NACDS speaks up for Rx amid debt ceiling debate

July 14th, 2011

ALEXANDRIA, Va. – As President Barack Obama and congressional Democrats and Republicans square off over raising the debt ceiling, the National Association of Chain Drug Stores aims to ensure that patient access to pharmacy services isn't curtailed.

NACDS said that on Wednesday it sent a letter to President Obama and House of Representatives and Senate leaders that spotlights critical community pharmacy services provided through federally funded programs such as Medicare, Medicaid and TRICARE, the health and drug benefits plan for the nation's armed forces.

"As you continue negotiations on the debt ceiling, the National Association of Chain Drug
Stores is writing to share our views on several proposals that are reportedly under consideration. We recognize that you are faced with an incredibly difficult task as the White House and Congress develop a comprehensive plan for debt reduction," NACDS stated in the letter to Obama. "However, we urge you to avoid cost-cutting initiatives that actually would bring about the unintended consequences of driving up health care costs in other areas, and at levels that are higher than the perceived savings."

Obama and Democratic lawmakers have been in a stand-off with House and Senate Republicans over whether to increase the federal debt ceiling, which would enable the government to borrow the funds it needs to continue to operate. The president and the Democrats have called for the ceiling to be raised and/or new taxes and other measures to boost government revenue, while Republicans are demanding that the administration institute spending cuts instead of raising the debt ceiling and paving the way for more borrowing.

The feud has pushed the government to the brink of default, and credit rating agencies have said the nation's debt rating could be downgraded if the matter isn't settled, a scenario that could bring dire consequences to the U.S. and global economies. Considering the gravity of the situation, talks for compromise measures — enabling more flexibility with the debt ceiling plus spending cuts and/or new revenue vehicles — gained steam this week.

In its letter, NACDS urged decision-makers to continue to enable access to diabetic testing supplies for Medicare patients, many of whom obtain these supplies from pharmacies. The letter also addressed how decreases in Medicare Part B prescription drug reimbursements could result in prescription access problems for Medicare patients. The association, too, called on decision-makers to exercise caution in attempts to cut costs in the TRICARE pharmacy program.

"Local pharmacies are an important health care access point and currently provide important preventive services to our nation's military, such as immunizations. If reductions to the TRICARE pharmacy program are considered, we urge you to be mindful of the importance of maintaining access and choice of provider for TRICARE beneficiaries. NACDS has a long history of partnering with the Department of Defense [DoD] to institute industry best practices to control prescription drug spending in the TRICARE program, and we are committed to continuing to do so," the letter stated.

Also, NACDS urged continued vigilance and a strategic approach to reducing waste, fraud and abuse in Medicare and Medicaid, which can hike costs instead of lowering them. "We believe the focus should be based on high risk providers, rather than creating one-size-fits-all initiatives that unfairly burden legitimate providers with a history of serving Medicare patients," the letter said.

In other news, NACDS on Thursday hailed the DoD's issuance of a final rule that widens the scope of retail pharmacy-provided vaccination services in TRICARE. The rule, due to go into effect Aug. 12, expands the ability of retail pharmacies to administer vaccinations to members of the armed forces, retirees and their families.

"We applaud the Department of Defense for expanding retail pharmacy's role in administering vaccinations for TRICARE beneficiaries," NACDS president and chief executive officer Steve Anderson said in a statement. "Pharmacy-provided vaccinations are important preventive healt hcare services, which can help prevent the spread of disease, improve patient health and reduce healthcare costs over the long term."

Under the interim final rule, released Dec. 10, 2009, retail network pharmacies were first recognized as providers and authorized to administer the H1N1, seasonal flu and pneumococcal vaccines to TRICARE patients, according to NACDS. For the first six months after publication of that interim rule, over 18,000 vaccines were administered in pharmacies. DoD estimates that over $1.5 million was saved by administering these vaccines through the pharmacy — rather than the medical —benefit.

The new final rule complements the interim final rule and further authorizes retail pharmacies to administer all vaccinations covered under the DoD's preventive care program, as permitted by state law, NACDS said. And similar to the interim rule, the final rule also waives all co-pays for TRICARE beneficiaries who get immunization services from network pharmacies, the association said.

Also on Thursday, NACDS endorsed the Restoring Access to Medication Act, which aims to repeal a provision of the Patient Protection and Affordable Care Act that requires consumers to get a prescription to use their flexible spending accounts (FSA) to buy over-the-counter medicine.

The legislation was introduced by Reps. Lynn Jenkins (R., Kan.) and Shelley Berkley (D., Nev.) and Sens. Pat Roberts (R., Kan.) and Ben Nelson (D., Neb.). An estimated 35 million-plus Americans rely on FSAs or other tax-deferred accounts for basic health care needs, and about 19 million use them for buying OTC medications, NACDS reported.

"This provision makes it more costly and more burdensome for millions of patients to obtain approximately 15,000 cost-effective over-the-counter medications. On a bipartisan basis, members of Congress have raised legitimate questions about whether this new restriction was the right way to go, and this legislation would answer that question in favor of cost-effective patient care," stated Anderson.

"By enacting this commonsense bill, Congress will lift an onerous burden on patients, pharmacies and health care providers and restore American families convenient access to effective, affordable and convenient health care products," he added.

NACDS previously endorsed similar legislation (H.R. 605/ S. 312) introduced by Rep. Erik Paulsen (R., Minn.) and Sen. Kay Bailey Hutchison (R. Texas), which repeals the prescription restriction and restores consumers' access to tax-deferred accounts for OTC purchases.

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