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ALEXANDRIA, Va. — The health care reform package signed into law by President Obama includes three pharmacy provisions advocated by the National Association of Chain Drug Stores.
Part of the bill passed by the Senate in December, the provisions will pilot medication therapy management (MTM) while improving the Medicare Part D MTM benefit, reduce Medicaid pharmacy reimbursement cuts under the average manufacturer price (AMP) model, and conditionally exempt pharmacies from durable medical equipment (DME) Medicare accreditation requirements.
“The important takeaway is that pharmacy’s provisions have been maintained through another step in this process,” says NACDS president and chief executive officer Steve Anderson. “Some very supportive leaders on Capitol Hill stepped up and kept these issues in the mix, and we appreciate their pro-patient, pro-pharmacy commitment.
“As we have said all along, advancing NACDS’ priorities will require continued vigilance as the legislative process unfolds … into a regulatory process — this in many ways is still the early stage of our campaign to advance pharmacy’s value and viability as the face of neighborhood health care. We very much appreciate and value those pharmacy champions in Congress who are standing with us.”
The advancement of NACDS-urged MTM provisions demonstrates results for the association’s vision that pharmacy will be preeminent in fostering medication adherence.
NACDS has emphasized pharmacy’s ability — through such services as MTM — to help reduce the estimated $290 billion in annual costs that result from poor medication adherence, amounting to 13% of all health care expenditures.
Regarding the Medicaid AMP issue, the legislation includes changes to provisions in the Deficit Reduction Act of 2005 that pertain to the definition of and method of calculating AMP. These changes, long advocated by NACDS and pharmacy allies, are essential to achieving a better approximation of pharmacies’ costs for purchasing generic drugs, according to the organization.
The bill also would ensure that federal upper limits are set using a multiplier of “no less than” 175% — much higher than the levels set under the 2005 statute, which NACDS says would cripple pharmacy’s ability to serve Medicaid patients.
NACDS and allied organizations fought to prevent congressional negotiations from settling on a multiplier of less than 175% and remain committed to working through the regulatory process to maximize the multiplier to advance pro-patient, pro-pharmacy policy. The “no less than” language is vital to this effort, they say.
The conditional exemption for pharmacy from the accreditation requirement for providing DME to Medicare beneficiaries would help maintain seniors’ access to needed products from their neighborhood pharmacies, notes NACDS. The association added that other such providers have been afforded this exemption.
The MTM, AMP and DME provisions were among the issues advocated strongly at the NACDS RxImpact Day on Capitol Hill event in Washington, D.C., last month.
During the lobbying push, more than 250 NACDS members, pharmacy school students and faculty, state pharmacy association representatives, and other pharmacy advocates conducted more than 220 meetings with elected officials.
In addition, more than 1,500 letters were sent to Capitol Hill during the “Virtual Hill Day” that supplemented the in-person meetings.
