Pharmacists Back Iowa Law Supporting Patient Access to Pharmacy Care
by NCPA | Sep 03, 2014
NCPA Opposes Lawsuit Filed against H.F. 2297
Alexandria, Va. Sept. 3, 2014 – National Community Pharmacists Association (NCPA) CEO B. Douglas Hoey, RPh, MBA, issued the following statement in response to announced litigation intended to thwart H.F. 2297, bipartisan legislation signed into law on March 14, 2014:
"NCPA has supported this bipartisan legislation all along because it is a common-sense solution and the right thing to do. For about a year now, the costs for scores of generic drugs have been skyrocketing by as much as 600%, 1,000% or more. The trend is well-documented by both an NCPA survey of more than 1,000 community pharmacists as well as by regional and national media outlets, including The New York Times and The Wall Street Journal.
"While the prices that pharmacies must pay their wholesalers for these medications continue to increase, insurance middlemen known as pharmacy benefit managers (PBMs) may wait months before they adjust reimbursement rates to reflect market costs, and rarely do so retroactively. This is forcing community pharmacies to ‘buy high’ and ‘sell low’ and routinely incur losses of $60, $100 or much more per prescription. That’s unsustainable for any small business and is already reducing patient access to pharmacy care.
"Iowa is one of 16 states to enact legislation to address this problem—nearly one-third of the nation. Iowa’s law should give the state’s 300-plus independent community pharmacies some basic insights into their reimbursement from PBMs for common generic drugs, as well as set forth an appeals process to hopefully resolve differences that may emerge if PBMs continue to reimburse community pharmacies at lower, outdated rates.
"In addition federal Medicare officials have finalized a regulation for 2016 Medicare prescription drug plans that grants patients and community pharmacists some of the same protections included in H.F. 2297. Medicare took this action after considering and rejecting the same specious arguments that the PBMs are making now against the bipartisan Iowa law. In fact there is a track record of alarmist PBM claims of enormous cost increases that do not hold up to scrutiny.
"In opposing H.F. 2297, the trade group for PBMs is grossly distorting the law’s provisions while trying to defend the indefensible—threatening patient access to medications by reimbursing pharmacies well below their cost of dispensing medications."
Lawsuit Challenges Iowa Health Mandate that Forces Employers to Pay More for Prescription Drugs A "Giveaway to the Drugstore Lobby" is Challenged in Federal Court
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WASHINGTON, Sept. 2, 2014 /PRNewswire-USNewswire/ — The Pharmaceutical Care Management Association (PCMA), the national association representing America’s pharmacy benefit managers (PBMs), today filed a lawsuit in Iowa federal court challenging a sweeping new Iowa law that restricts tools used by PBMs to lower prescription drug costs for the state’s employers and consumers.
The law—HF 2297—forces PBMs to overpay for generic drugs by severely restricting the use of Maximum Allowable Cost (MAC) lists that keep generic drug costs reasonable. PBM customers, like employers and public programs, rely on MAC lists to prevent overpayments to drugstores. Specifically the new law:
Forces employers, unions and public programs to pay drugstores more for certain drugs.
Makes it harder to reduce drug benefit costs when less expensive generics come to market.
Entitles drugstores to extra "retroactive" payments if they claim past reimbursements weren’t large enough.
"This mandate forces Iowa employers, unions and public programs to pay drugstores above-market rates. It’s a giveaway to the drugstore lobby that will raise Iowa’s prescription drug costs by $55 million a year with no upside," said PCMA President and CEO Mark Merritt.
MAC lists are widely used by health plans and PBMs to reduce costs for private-sector clients, union health and welfare funds, Medicaid and Medicare Part D. Forty-five state Medicaid programs now use MAC lists, up from 26 states in 1999.
PCMA represents the nation’s pharmacy benefit managers (PBMs), which improve affordability and quality of care through the use of electronic prescribing (e-prescribing), generic alternatives, mail-service pharmacies, and other innovative tools for 216 million Americans.
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SOURCE Pharmaceutical Care Management Association (PCMA)
