Pharmacists React to Medicare’s Proposed Changes for 2015 Drug Plans

Published Online: Tuesday, January 7, 2014
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ALEXANDRIA, Va. (Jan. 7, 2014)National Community Pharmacists Association (NCPA) CEO B. Douglas Hoey, RPh, MBA, issued the following statement today in response to policy changes proposed by the U.S. Centers for Medicare & Medicaid Services (CMS) for Medicare Part D prescription drug plans (PDPs) in 2015:

“While we are still reviewing the proposed rule, we have some initial observations.

“First, we are encouraged by CMS’ response to problems with preferred pharmacy networks. CMS’ proposal to allow any willing pharmacy to offer a plan’s lowest, or ‘preferred,’ cost-sharing should help level the playing field for community pharmacies to participate in these plans and should benefit seniors by giving them more competition and choice among pharmacies in their drug plan.

“Second, we appreciate CMS’ efforts to address concerns over maximum allowable cost (MAC) pricing, particularly in the wake of soaring costs for certain generic drugs. Giving community pharmacists both greater transparency into the MAC-setting process and more assurance that MACs should be updated frequently to reflect real-world costs is the least that prescription drug plans should do.

“Third, we strongly support CMS’ move away from co-pay arrangements that incentivize the use of mail order over retail. Research utilizing Medicare’s own data found that community pharmacies offered 90-day supplies of medication at lower cost and that these pharmacists did a better job promoting the proper use of cost-saving generic drugs compared to mail order.

“In addition, we commend CMS for proposing to expand coverage of medication therapy management (MTM) services. And we thank the agency for recommending a prohibition on reimbursement methods, such as pro-rated dispensing fees, that penalize long-term care pharmacies for adopting dispensing techniques that are intended to reduce medication waste.

“For years NCPA members, staff and patients have raised these and other issues for CMS’ attention. We appreciate the steps that the agency is taking to address these concerns. We look forward to continuing to work with the CMS and other policymakers to preserve these proposals in the final 2015 regulations to be issued later this year.”
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