NCPA Advocacy Center Update – Week Ending February 11, 2017

NCPA Responds to PBM Efforts to Limit Potential Reforms:  An apparently leaked memorandum has surfaced from Mark Merritt, president and CEO of the Pharmaceutical Care Management Association (PCMA), to the association’s board of directors. It outlines PCMA’s strategies to mitigate possible reforms of PBMs. NCPA responded to news surrounding the leaked memo by stressing  the untold profits PBMs have extracted from patients, drug manufacturers and health plans, with very little oversight and almost no transparency. PBMs’ business model is contributing to the problem of rising drug costs—as well as the resulting medication access and affordability challenges those costs create for patients. As evidence, consider PBM manipulation of pharmacy DIR fees in the Medicare Part D space. NCPA wholeheartedly agrees with Medicare officials that PBM manipulation of pharmacy DIR fees increases costs to the government and raises beneficiary out-of-pocket costs for medications. Those retroactive fees also threaten the viability of some independent pharmacies. The growing PBM share of rebates from drug manufacturers is another example of how PBMs profit right along with higher prices.

Senate confirms Price to lead Department of Health and Human Services:  The U.S. Senate confirmed Representative Tom Price (R-Ga.) as the nation’s top health care official, putting him in charge of the Department of Health and Human Services (HHS).  Price’s confirmation came by a slim 52-47 margin, ending weeks of partisan bickering marked by ethics allegations and breaks with Senate tradition. The seven-term congressman maintained full Republican support throughout ensuring his path to HHS secretary was never in real danger. No Democrats voted for him.  The highly partisan opposition to his nomination served as a preview of the fight to come over the future of American health care. Price’s confirmation represents the last major piece Republicans say they need to start dismantling the Affordable Care Act (ACA). After more than seven years of waiting, the GOP must now figure out how exactly they will go about repealing and replacing a law that provides coverage to 20 million people with no help from Democrats, who vowed to fight ACA replacement.

Senate Schedules Hearing for CMS Nominee:  The Senate Finance Committee announced that it will hold a hearing on February 16th to consider the nomination of Seema Verma, President Trump’s pick to head the Centers for Medicare and Medicaid Services (CMS).  Verma, a health policy consultant was the architect behind cost-cutting reforms to Indiana’s Medicaid program, requiring recipients to make payments, undertaken when Vice President Mike Pence was governor. She will likely face heavy scrutiny from Democrats for her work on conservative reforms to several state Medicaid programs and if confirmed will likely play a crucial role in any Republican attempt to overhaul Medicaid.

Shape the New Health Care Laws This Year at the Congressional Pharmacy Fly-In:  This is a critical time for your pharmacy! Ensure community pharmacy is heard as lawmakers replace the Affordable Care Act. Join the NCPA Congressional Pharmacy Fly-In April 26-27 in Washington, D.C. It’s much shorter and more affordable this year so you can come to Capitol Hill and advocate for your patients and your business. Help us urge lawmakers to ban retroactive pharmacy DIR fees, support ‘any willing pharmacy’ legislation, fight mandatory PBM mail order, and enact pharmacist provider status legislation.  Register now online or by calling 1-800-544-7447 and make your voice heard in the halls of Congress.

Pharmacy Orgs Weigh in On Final FDA Biosimilar Naming Guidance:  This week NCPA, NACDS and APhA sent a letter to the Office of Management and Budget expressing our concerns regarding the impact that the FDA’s proposal for renaming all biological drugs will have on pharmacists and pharmacies, especially those in the community setting. The Guidance document “Nonproprietary Naming of Biological Products,” requires renaming every biological drug, including drugs that have been marketed for years under a different nonproprietary name, by assigning a random four letter suffix for use in conjunction with the international nonproprietary name (INN).   We are concerned that our members will have to engage in unnecessary workload and workflow changes which will impact patient care. Our organizations request that the Office of Management and Budget suspend further implementation of the policy until its resulting patient impact and costs have been fully identified, analyzed and addressed.

Act Now to Protect Pharmacy CompoundingPlease urge your Representative to join an effort led by Reps. Chris Stewart (R-Utah) and Buddy Carter (R-Ga.) to get the Food and Drug Administration to rescind its final rule forbidding 503A pharmacies from compounding for office use. (Use the “Find Officials” tool in the NCPA Legislative Action Center for contact information about your member of the House of Representatives.) FDA has finalized a guidance that would limit office use compounding to 503B pharmacies, outsourcing facilities registered with the FDA. It’s imperative that FDA hear from members of Congress that this guidance be rescinded and reissued to include traditional state-regulated 503A pharmacies.  The deadline for Representatives to add their names to the letter is Feb. 17. Please have your Representative’s office contact Luci Arveseth in Stewart’s office at to support community pharmacies.

In the States:

  • California: A.B. 315 was introduced and would require PBMs to be licensed by the SBOP. The bill would also require PBMs to disclose how much they are saving employer clients and consumers on an annual basis.
  • Nebraska: NCPA submitted a letter of support for L.B. 474 which would allow a pharmacist to provide medication synchronization services to patients.
  • Hawaii: NCPA submitted a letter of support for S.B. 1138 which would require PBMs to register with the Insurance Commissioner.
Posted in Legislation

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