NCPA Advocacy Center Update – Week Ending March 16, 2018

Only Hours Remain to Obtain Group Rate for Congressional Pharmacy Summit Hotel
The deadline to reserve your room at NCPA’s group rate for the Congressional Pharmacy Summit is midnight tonight. If you have not registered and made your hotel reservation, don’t miss your opportunity to take advantage of the savings on your room. If you need additional inspiration, view this invitation from pharmacy champion, Congressman Doug Collins (R-Ga.) expressing the importance of pharmacist attendance. At this year’s Congressional Pharmacy Summit, you’ll have several CE opportunities as we provide you with a legislative briefing and the latest Medicare and Medicaid updates. Then it’s off to Capitol Hill to meet with your legislators to advocate for common sense policy to address issues important to community pharmacies. See the attached agenda for more informationRegister today to reserve your spot at the Summit and save money on your hotel room (the special NCPA rate disappears at 12:01 ET.)  Don’t pass up this opportunity to lobby for your patients and your business.

NCPA Offers Opioid Recommendations to Key Committee
In a letter to the chairman and ranking member of the House Ways and Means Subcommittee on Health this week, NCPA offered several suggestions on how to combat the ongoing opioid crisis. These included enhancing Prescription Drug Monitoring Programs to increase the ability to track prescriptions for controlled substances, prioritizing health care provider education and increasing use and access to Medication Assisted Treatment (MAT). NCPA continues to take every opportunity to offer solutions to the opioid crisis from the independent pharmacy perspective.

U.S. Senate and House Continue Opioid Epidemic Efforts

  • This week, Senators Charles Grassley (R-Iowa), Dianne Feinstein (D-Calif.), John Kennedy (R-La.) and Dick Durbin (D-Ill.) introduced the Opioid Quota Reform Act of 2018, which would enhance the opioid quota setting authority of the Drug Enforcement Administration (DEA).  The bill would improve transparency and permit DEA to adjust quotas to prevent diversion and abuse. The Senators believe the legislation is needed to address significant increases in aggregate opioid production quotas.
  • The House Energy and Commerce Health Subcommittee will hold a two-day hearing March 21st and 22nd on 25 opioid-related bills.  The legislation, focused on public health prevention, includes measures that would address:  substance use disorder treatment, recovery and overdose prevention; medication-assisted treatment; tribal addiction and recovery activities; dissemination of information on opioid strategies; Food and Drug Administration (FDA) enforcement, drug approval and breakthrough pathway activities; opioid-related infectious diseases; pain management education; Prescription Drug Monitoring Programs; poison center networks; FDA opioid labeling; National Institutes of Health research flexibility; opioid alternatives; medical workforce; synthetic drug use; and laboratory testing for fentanyl.  NCPA is currently reviewing all of the measures to assess any potential impact on NCPA members.
  • The House Energy and Commerce Oversight & Investigations Subcommittee will hold a hearing on March 20th regarding the Drug Enforcement Administration’s (DEA) role in combatting the opioid epidemic.  DEA Acting Administrator Robert Patterson will be the only witness at the hearing focused on concerns arising from the committee’s ongoing bipartisan investigation into alleged pill dumping in West Virginia.

Senators Seek to Eliminate Pharmacy Gag Clauses
This week, NCPA endorsed two new pieces of legislation introduced by a bipartisan group of Senators to address the challenge of pharmacists being constrained from helping patients find the best price for their prescription drugs. S. 2553, the Know the Lowest Price Act of 2018, would allow pharmacists to tell Medicare Part D beneficiaries if the cash price for a prescription drug is lower than the price through their insurance coverage. S. 2554, the Patient Right to Know Drug Prices Act, would apply the same protections to plans covered under the Affordable Care Act health care exchanges and ERISA plans provided by private employers. Both bills were introduced by Sens. Susan Collins (R-Maine), Claire McCaskill (D-Mo.), John Barrasso (R-Wyo.), Debbie Stabenow (D-Mich.) and Bill Cassidy (R-La.) while Sen. Ron Wyden (D-Ore.) joined as an original cosponsor of the Know the Lowest Price Act.

PBMs in Policymakers’ Crosshairs
According to a story this week in an influential DC publication, policymakers are focusing on PBMs and their role in increasing drug prices. The article, entitled “Pharmaceutical Middlemen Feel the Squeeze” (see attached) ran in the National Journal, a source read by almost all policymakers and their staff. The article referenced the bipartisan congressional letters supporting CMS’ proposal in the proposed rule for the 2019 Medicare Part D plan year to account for all pharmacy DIR at point of sale, an effort NCPA lead. It further highlighted statements from Trump administration officials, including HHS Secretary Alex Azar that call out PBMs for their role in drug pricing.

Ohio Officials Call Out PBM Practices in Press Conference
In a press conference this week, Ohio policymakers said they’re looking at the practices of PBMs and sudden, sharp reimbursement cuts in Medicaid Managed Care. Calling it a “PBM oligopoly,” they say PBMs are boosting their profits by overcharging insurers for medications and often reimbursing pharmacists less than the cost of the drug. They point out that 165 Ohio pharmacies — most of them in high Medicaid areas — have closed in the past two years. The press conference video runs for about 30 minutes, but it is worth watching. Thank you to the Ohio Pharmacists Association for their great (and ongoing) work to bring this issue to policymakers’ attention.

Arkansas Governor Signs PBM Oversight Legislation
Arkansas Governor Asa Hutchinson signed into law Thursday a landmark bill requiring pharmacy benefit managers (PBMs) to be licensed by the state. The bill is a direct result of an organized effort by Arkansas pharmacists to address drastic cuts in reimbursements. The bill, one of the most comprehensive in the nation, requires PBMs that service any insurance plans that are not self-funded to be licensed. The bill would not have succeeded without the hard work of the Arkansas Pharmacists Association and hundreds of independent community pharmacists in the state who advocated strongly for its passage. 

In the states …

Alabama HB 457, which addresses pharmacy audits, passed the House and is now in the Senate. 

Maryland HB 1349, which addresses MAC transparency, passed out of the House committee.

Maryland SB 576, which prohibits PBMs from restricting pharmacists from providing information to patients on medication costs, passed the Senate and is now in the House.

Missouri HB 1542, which prohibits PBMs from restricting pharmacists from providing information to patients on medication costs, charging patients a copay higher than the amount retained by the pharmacy, and charging certain retroactive fees, passed the House and is now in the Senate.

New Hampshire SB 591, which prohibits PBMs from requiring that providers to obtain certain accreditation, passed the Senate and is now in the House.

Tennessee SB 1852, which requires PBMs to be licensed by the state, passed the Senate and is now in the House.

Virginia HB 1177, which prohibits PBMs from restricting pharmacists from providing information to patients on medication costs, charging patients a copay higher than the cash price for the drug, restricting pharmacies from providing ancillary delivery services, and charging adjudication fees, was approved by the governor.

West Virginia SB 46, which prohibits PBMs from restricting pharmacists from providing information to patients on medication costs, passed both chambers and is awaiting the governor’s signature.