ncpa SPEAKS OUT: Medicaid Actions, Pharmacy Reactions

APRIL 01, 2007
Bruce Roberts, RPh

The National Community Pharmacists Association (NCPA) recently had what I believe was a very successful conference call with state pharmacy association executives, buying groups, and other pharmacy leaders on Medicaid. We are all on the same page on 3 critical points:

•Many of our pharmacists serve communities with limited access to health care providers. If pharmacies are forced to close their doors or drop out of government-backed health programs, patient access to the medicines they need will be seriously threatened.

•A regulation proposed by the Centers for Medicare & Medicaid Services (CMS) defines Average Manufacturer Price in a way that will not cover our members'actual acquisition costs of generic drugs, so the definition must be changed via the regulation or through federal legislation. Our Coalition for Community Pharmacy Action, a collaboration between the NCPA and the National Association of Chain Drug Stores, is working on that right now.

•The national cost of dispensing a prescription is $10.50, according to a study supported by the Community Pharmacy Foundation. As a result, dispensing fees must be increased through state-by-state legislative or regulatory action.

A similar conference call for the media featured 4 of our members, all of whom spoke straight from the heart about the devastating impact the pending Medicaid cuts would have on their patients and communities. Special thanks to:

•Jerry Shapiro, Uptown Drug & Gift Shoppe, Los Angeles, Calif

•John Mitchener III, Mitchener's Pharmacy, Edenton, NC

•Evan Vickers, Bulloch's United Drug Store, Cedar City, Utah

•Richard Peters, Glen Raven Pharmacy, Burlington, NC

You can listen to the news conference at and read or download some of the materials we discussed, including fact sheets, pharmacy access maps, links to government documents, and other resources at

In addition, there is a news release on a survey many independent community pharmacists filled out asking them if the proposed regulation from CMS—which the independent Government Accountability Office has determined would pay pharmacies 36% below their acquisition cost for Medicaid prescriptions—would affect their decision to participate in the program. Of >800 pharmacists responding, 86% said it would influence their decision, 3.4% said it would not, and 8.4% were unsure. Only 1.8% of respondents are not currently participating in the Medicaid program.

During the conference call and in the release, we stressed the widespread consequences these wrong-headed policies could have. As NCPA President John Tilley noted:

"In thousands of communities across the nation, the local community pharmacy is a vital, indispensable community health resource. Government policies that drive independent community pharmacies out of Medicaid, or even out of business, will result in increased costs to taxpayers in terms of emergency room visits, hospitalizations, and other unintended health consequences. A pharmacy closed because of Medicaid regulations means its Medicare and all its other patients lose, too."

Mr. Roberts is executive vice president and chief executive officer of the National Community Pharmacists Association.

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