PBM Practices Exposed at Senate HELP Hearing on Drug Pricing: On Tuesday, the Senate Health, Education, Labor, and Pensions (HELP) committee held a hearing on how the drug delivery system affects drug pricing. Representatives on behalf of the brand and generic pharmaceutical industry, the distributor industry, PBMs, and the American Pharmacists Association testified on how each group impacted drug pricing. Senator Collins focused her questions toward the PBM representative, specifically with regards to the NBC story that aired this week on PBM clawback practices at the pharmacy counter. The PBM representative stated that they believe this practice is wrong and that any PBM engaged in this practice is an “outlier.” Despite this answer, Senators Kaine, Baldwin, and Murkowski noted PBM price transparency is necessary and mentioned strong support for efforts to accomplish increased transparency. To this end, NCPA submitted comments for the record citing the need for PBM transparency and highlighted the proliferation of DIR fees in Medicare Part D. NCPA will continue to monitor the growing support for drug pricing transparency.
House E&C Committee to Hold Hearing on Opioid Crisis: On October 25th, the House Energy and Commerce Committee will hold a full committee hearing on the opioid crisis, entitled, “Federal Efforts to Combat the Opioid Crisis: A Status Update on CARA and Other Initiatives.” The following witnesses are slated to testify: Neil Doherty, Deputy Assistant Administrator, Office of Diversion Control, Drug Enforcement Administration (DEA); Dr. Scott Gottlieb, Commissioner, Food and Drug Administration (FDA); Dr. Elinore McCance-Katz, Assistant Secretary for Mental Health and Substance Use, Substance Abuse and Mental Health Services Administration (SAMHSA); Dr. Anne Schuchat, Principal Deputy Director, Centers for Disease Control and Prevention (CDC); and Dr. Nora Volkow, Director, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH). NCPA has learned that the committee is interested in working on new opioid legislation following the hearing. NCPA is monitoring several opioid related bills that could be included in any future legislation and has provided guidance to the bill authors to ensure patients have access to legitimately needed drugs, while also preventing diversion and abuse of prescription drugs.
Azar Rumored to be HHS Secretary Nominee: Several media outlets have reported that President Trump is leaning toward nominating Alex Azar, a former pharmaceutical industry executive and George W. Bush administration official, to serve as Health and Human Services (HHS) Secretary. If chosen, Azar would replace former Secretary Tom Price, who resigned in September. Azar is a veteran of HHS. He served as the department’s general counsel and deputy secretary during the Bush administration. While at the department, he worked closely with Eric Hargan, who was confirmed earlier this month as Trump’s deputy HHS secretary and has been acting secretary since Price’s Sept. 29 departure. Azar has spent most of the past decade inside the drug industry, one of the key sectors he’ll regulate at HHS. Azar joined pharmaceutical giant Eli Lilly and Company in June 2007 as a senior vice president of corporate affairs and communications right after leaving the Bush administration. He rose to head Lilly’s U.S. operations in 2012, a position he held until this January, when he left the company. Azar earlier this year called on the insurance and drug industries to work together to lower drug prices, where he remarked that patients are paying too much for drugs.
The Limited, Bipartisan Affordable Care Act (“ACA”) Stabilization Bill: Last week, President Trump announced that the federal government would cease paying cost-sharing reduction (“CSR”) payments to health insurance providers as provided in the ACA. This week, the Senate proposed a plan to save these CSR payments, while giving the states more flexibility from the ACA. There are two key provisions of the proposed legislation. First, the legislation permanently amends the ACA to give new flexibility for states to create insurance policies that have a larger variety and lower costs. This would include enabling states to offer a new catastrophic plan for all ages, encouraging interstate agreements, streamlining the ACA section 1332 State Innovation Waivers, and changing the law to make it easier for states to write new policies. Second, the legislation would continue CSR payments in 2018 and 2019. In a speech on Thursday afternoon, Committee Chairman Lamar Alexander (R-TN) stated President Trump called him directly about this legislation, noting he had cut off the ACA’s CSR subsidies, intends to advance a block grant approach to replace the ACA, but does not want people to suffer in the meantime; therefore, the President indicated he would be open to a bipartisan, short-term agreement, with short-term CSR funding included to get a “better deal” with Democratic Senators. The Senate has not voted on this legislation. NCPA will closely monitor any changes and impacts this legislation may have in the coming days.
Representative Carter at NCPA Annual Convention: NCPA was pleased to have Rep. Buddy Carter (R-Ga.) join us at the NCPA Annual Convention where he received two well-deserved standing ovations as he spoke at a general session. Carter, the only pharmacist in Congress, said he’ll continue to fight for transparency in prescription pricing and against the overreach of PBMs. And he encouraged every owner to invite their member of Congress to visit and see the work that pharmacists do every day on the front lines of health care. (Contact us and we’ll help you plan for a successful visit.) Additionally, the NCPA Political Action Committee (NCPA PAC) hosted a fundraising reception raising nearly $30,000 from NCPA members to benefit Carter’s re-election campaign.
Another Great Convention Is in the Books: The NCPA 2017 Annual Convention in Orlando, Fla, a gathering of some 3,000 pharmacists, students, and exhibitors, was a great chance to explore the opportunities, solutions, and profits ahead for the $79.8 billion business of independent community pharmacy. Find additional reports and pictures from the convention on social media by searching for the hashtag #NCPA2017. And look for a deep dive on all things convention in the January issue of America’s Pharmacist.
Hot Off the Presses: 2017 NCPA Digest: The 2017 NCPA Digest, sponsored by Cardinal Health, offers a wealth of information about the state of pharmacy today. This year’s Digest shows us that independent community pharmacies remain indispensable for patients, especially in underserved communities. And that’s because the quality of services is growing as pharmacists find new ways to drive better health outcomes for their patients. Community pharmacists make a difference because they are an integral part of the communities they serve.
In the News:
- Check out this NBC Nightly News segment on PBM clawback practices.
