NCPA Advocacy Center Update – Week Ending February 23, 2018

NCPA member Richard Logan to testify before Congress next week: The House Energy & Commerce Subcommittee on Health has scheduled a hearing on the opioid crisis entitled “Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety” at 1 pm ET on Wed., February 28th. NCPA member Richard Logan, Jr., Pharm.D. who owns two pharmacies in Missouri and is a recently retired drug diversion investigator with the Mississippi County, MO Sheriff’s Department, will testify on behalf of NCPA. In conjunction with the hearing, the subcommittee announced it is considering eight bills. The hearing is part of a push that full committee Chairman Greg Walden (R-Ore.) announced recently to enact new legislation (and continue parallel, investigative oversight work) to combat the opioid epidemic. Among the legislation the subcommittee will consider is H.R. 4275, the Empowering Pharmacists in the Fight Against Opioid Abuse Act, legislation NCPA previously endorsed, which would facilitate DEA resources to support pharmacists’ decisions whether to fill prescriptions for certain controlled substances. Remarkably, the hearing will be NCPA’s third appearance in three months before the influential subcommittee.

In addition, the Senate Health, Education, Labor & Pensions (HELP) Committee will hold a Feb. 27 hearing entitled “The Opioid Crisis: The Role of Technology and Data in Preventing and Treating Addiction.” This is at least the committee’s fifth hearing on the subject. NCPA previously submitted a statement for the record to the panel to help inform its legislative work.

NCPA nominates Troy Trygstad to MedPAC: NCPA today sent a letter (attached) to GAO nominating Dr. Troy Trygstad, Pharm.D., PhD, M.B.A. for appointment to the Medicare Payment Advisory Commission (“MedPAC”), a nonpartisan, legislative branch agency that advises Congress on the Medicare program. Dr. Trygstad is currently the Executive Director of CPESN USA, LLC, a nationwide clinically integrated network of more than 1,200 community pharmacies; and Vice President of Pharmacy and Provider Partnerships, CCNC, Inc., a statewide network of more than 2,000 primary care practices and 14 care management and primary care provider support networks and more than 100 supporting pharmacists.

 House Judiciary Subcommittee to Review Proposed CVS-Aetna merger: On Feb. 27, the House Judiciary Subcommittee on Regulatory Reform, Commercial and Antitrust Law will hold a hearing to examine the proposed merger of CVS Health and Aetna and its competitive impacts “on consumers and the health insurance, pharmacy benefit managers (PBMs), and retail pharmacy markets.” NCPA will provide to the subcommittee a statement for the record articulating the views of community pharmacists. 

New White Papers Look into State Efforts to Address Prescription Drug Costs: The National Academy for State Health Policy published a white paper “How the Federal Government Can Help States Address Rising Prescription Drug Costs” that identified a range of challenges and recommendations for federal and state policymakers. They include:

  • “Examine pharmacy benefit manager (PBM) pricing impact on drug costs for states and consumers: The inspector general should require PBMs to disclose how much of manufacturers’ discounts are passed on to their health plan clients, and should examine the extent to which any price concessions not ‘passed through’ are included in manufacturer calculations of Medicaid ‘best price,’ which is the intent of current regulations.”
  • “Allow Medicaid agencies to create pharmacy networks to negotiate lower costs: States would like the option to create a statewide Medicaid pharmacy network and/or contract with specialty pharmacies for either their fee-for-service population, or to carve out some drugs from health plan contractor management and move to a statewide retail network or specialty pharmacy contractor.”

The Kaiser Family Foundation separately published “Snapshots of Recent State Initiatives in Medicaid Prescription Drug Cost Control”, an interesting look at various efforts including drug growth caps, closed formularies, promoting low price generic drugs and PBM transparency laws. 

Help inform NCPA comments to CMS on mail order waste: CMS recently proposed changes to its approach concerning patient consent requirements for auto-shipped medication in Part D. Please answer a few questions as we prepare comments to the agency.

Come give Congress a piece of your mind about PBMs: Be part of the NCPA Congressional Pharmacy Summit April 11-12 in Alexandria, Va. Community pharmacists will storm Capitol Hill and make their voices heard on DIR fees, MAC transparency and more. Sign up today: 

In the States:

  • New Resource: PBM Regulation by State: A new resource compiled by NCPA’s state governmental affairs division maps the patchwork of PBM regulation state-by-state. It’s intended to assist our state partners in briefing legislators about the range of PBM regulation across the country. The map shows which states have enacted PBM licensure or registration, MAC transparency, fair audit provisions, or some combination of the three.
  • Arkansas pharmacists call out PBM abuses: In a remarkable news conference this past week, the Arkansas Pharmacists Association shed light on several egregious PBM abuses, including reimbursement cuts in the Arkansas Works program and price differences between what PBMs pay their own pharmacies and what they pay independent pharmacies for the same claim. As APA’s Scott Pace said: “Pharmacists take care of people, folks, and that’s what they’re trying to do … The situation is unsustainable and it requires a fix.” It’s well worth a listen and a share.