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ALEXANDRIA, Va. – Congress may be stalling in its work to advance reforms of pharmacy benefit managers, but others in Washington are pressing on with their efforts – and they’re looking to independent pharmacy owners for their experiences and important perspectives.
At a roundtable event at the White House on Monday, March 4, two members of the National Community Pharmacists Association were invited to join a lineup of participants that included Federal Trade Commission Chair Lina Khan and Health and Human Services Secretary Xavier Becerra. The roundtable focused on anticompetitive PBM practices that drive up drug costs for American families, limit patient choice, and squeeze community pharmacies. Dared Price, PharmD, of Graves Drug in Kansas and Oread Rx (a transparent, pass-through PBM) and Chichi Ilonzo Momah, PharmD, who has owned Springfield Pharmacy in Pennsylvania since 2012, were among the select group of private sector speakers.
Price, who is also a member of NCPA’s Board of Directors, specifically urged policymakers to end take-it-or-leave-it PBM contracts, cutthroat reimbursements, and patient-steering tactics. From the viewpoint of Oread Rx, he stressed that the largest PBMs take advantage of the opaque system that allows for numerous misaligned incentives and multiple ways for them to shift and hide unknown revenue streams. He also emphasized that state legislative efforts protecting patients from PBMs’ conflicts of interest do not raise health insurance costs, despite claims to the contrary. Momah shared examples of patients for whom she’s helped fight PBM red tape, imploring policymakers to enforce regulations already in place; consider a cost-plus reimbursement model in Medicaid managed care programs and Medicare Part D; and pay pharmacies transparently and fairly based on acquisition cost plus a commensurate cost to dispense fee.
Later Monday, NCPA President Lea Wolsoncroft, owner of Remedies Pharmacy in Alabama, spoke at a virtual town hall cohosted by NCPA and other partners of the Small Business Rising Coalition that focused on reining in monopoly power and leveling the playing field for small, independent businesses. FTC Chair Lina Khan participated in this event, too, and spoke about looking beyond efficiencies to assess whether dominant firms are taking advantage of unfair privilege to get ahead. During the Q&A session, Wolsoncroft asked Khan about the merger guidelines released by the FTC and Department of Justice in December and whether their “route to market” terminology and changes to how the agencies would examine the market share of merged firms with a market share of over 30 percent were made in contemplation of PBMs. Khan didn’t comment on how the guidelines would apply to any specific industry, but she said it’s no secret that the agency is scrutinizing PBMs after hearing from independent pharmacists, patients, and others about their practices.
To watch the White House roundtable, click here. The independent pharmacists’ remarks as prepared for delivery can be found here.
To watch the virtual town hall, click here.
