CCPA Speaks Out: Pharmacy Awaits Outcome of Key Legislation

Author: Julie Khani and Charles Sewell


Ms. Khani and Mr. Sewell are copresidents of the Coalition for Community Pharmacy Action.



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As the weather heats up, community pharmacy is at the forefront of health care policy being debated in Congress. On the table are 2 key pieces of legislation that could have major impacts on pharmacies' ability to provide prescription drugs and services to their patients.

In the long-awaited Medicare legislation introduced by Senate Finance Committee Chair Max Baucus (D, MT) last month, the pharmacy community achieved several victories. First, the Medicare Improvements for Patients and Providers Act (S 3101) includes a delay of Medicaid pharmacy payments based on the Average Manufacturer Price (AMP) through September 30, 2009. The bill also delays public posting of AMP data through that time. In addition, the bill includes other pharmacy priorities, including financial incentives for electronic prescribing and requirements for the prompt payment of Medicare Part D claims.

Julie Khani
Vice president
of federal
healthcare
programs at
NACDS

Charles Sewell
Senior vice
president
of government
affairs at
NCPA

As a delay of the Medicaid AMP cuts is not a permanent solution, we continue to urge Congress to enact The Fair Medicaid Drug Payment Act (S 1951)—legislation that would help fix the drastic cuts to Medicaid reimbursement levied by the Deficit Reduction Act of 2005 (DRA). The bill now has 49 cosponsors in the Senate, and we are working to increase that number to 50 or more.

While the Coalition for Community Pharmacy Action (CCPA)—in conjunction with the National Community Pharmacists Association and the National Association of Chain Drug Stores—pushes here in Washington for support for our nation's community pharmacies and the low-income patients we serve, we need you—the community pharmacist—to weigh in with your lawmakers. The cuts in the DRA represent a 78% decrease in reimbursement rates—something that could result in 10,000 to 12,000 store closures nationally. The prescription drug service interruptions this could cause for America's low-income population could be disastrous.

It is not just Medicaid reimbursements that need your support. Earlier this year, Reps Steve Buyer (R, IN) and Jim Matheson (D, UT) introduced a bill in the House that has the potential to cost pharmacies dearly. The Safeguarding America's Pharmaceuticals Act of 2008 (HR 5839) would mandate electronic pedigrees (e-pedigrees) to track and trace each prescription drug through the supply chain, from manufacturer to distribution center to pharmacy. Although this may sound simple, these systems have not been tested on a wide scale, are unproven, and could cost pharmacies tens of thousands of dollars to implement. Multiplied over 55,000 retail pharmacies, that results in a more than $1-billion unfunded mandate on American community pharmacies.

The Coalition for Community Pharmacy Action (CCPA) is an alliance between the National Association of Chain Drug Stores (NACDS) and the National Community Pharmacists Association (NCPA), which together represents more than 55,000 community pharmacies. CCPA leverages the support, effort, and infrastructure of NACDS and NCPA while engaging community pharmacy to participate and advocate on issues affecting the industry.

Unfortunately, mandating e-pedigrees and track-and-trace technologies is a solution in search of a problem. There is no "crisis of counterfeit drugs" in the United States; both the FDA and the World Health Organization say prescription drug counterfeiting in this country is rare. We support steps to help strengthen the already safe prescription drug delivery system and would eventually like to see a federal system. HR 5839, however, is the wrong answer.

It is our job to deliver this message to Congress, but we need your help. Groups supporting the bill are working hard to pick up cosponsors and gain momentum. Lawmakers say their constituents are clamoring for new supply chain safety measures. We need you to become a voice of health care authority in your states and districts by calling and writing your members of Congress and telling them to oppose HR 5839.

It is an absolutely critical time for community pharmacy. The coming months may provide our best opportunity to get a permanent legislative fix for the AMP system and Medicaid reimbursements. Likewise, we have the chance to weigh in with Congress on the safety of the drug supply chain. As the most accessible health care providers in the country, it is our responsibility to do so.