Ms. Khani and Mr. Sewell arecopresidents of the Coalition forCommunity Pharmacy Action.
As the weather heats up, communitypharmacy is at theforefront of health care policybeing debated in Congress. On the tableare 2 key pieces of legislation that couldhave major impacts on pharmacies' abilityto provide prescription drugs and servicesto their patients.
In the long-awaited Medicare legislationintroduced by Senate FinanceCommitteeChair Max Baucus (D, MT)last month, the pharmacy communityachievedseveral victories. First, theMedicareImprovements forPatientsand ProvidersAct(S 3101) includes a delayof Medicaid pharmacy paymentsbased on the AverageManufacturer Price (AMP)through September 30,2009. The bill alsodelayspublic posting of AMP datathrough that time. In addition,the bill includesotherpharmacy priorities, including financialincentives for electronic prescribing andrequirements for the prompt payment ofMedicare Part D claims.
As a delay of the Medicaid AMP cutsis not a permanent solution, we continueto urge Congress to enact The Fair MedicaidDrug Payment Act (S 1951)—legislationthat would help fix the drastic cutsto Medicaid reimbursement levied bythe Deficit Reduction Act of 2005 (DRA).The bill now has 49 cosponsors in theSenate, and we are working to increasethat number to 50 or more.
While the Coalition for CommunityPharmacyAction (CCPA)—in conjunctionwith the National Community PharmacistsAssociation and the National Associationof Chain Drug Stores—pusheshere in Washington for support for ournation's community pharmacies and thelow-income patients we serve, we needyou—the community pharmacist—toweigh in with your lawmakers. The cutsin the DRA represent a 78% decrease inreimbursement rates—something thatcould result in 10,000 to 12,000 storeclosures nationally. The prescription drugservice interruptions this could cause forAmerica's low-income population couldbe disastrous.
It is not just Medicaid reimbursementsthat need your support. Earlier this year,Reps Steve Buyer (R, IN) and Jim Matheson(D, UT) introduced a bill in the Housethat has the potential to cost pharmaciesdearly. The Safeguarding America'sPharmaceuticalsAct of 2008(HR 5839) would mandateelectronic pedigrees (e-pedigrees)to track and trace eachprescription drug through thesupply chain, from manufacturerto distribution center topharmacy. Although this maysound simple, these systemshave not been tested on awide scale, are unproven, andcould cost pharmacies tens of thousandsof dollars to implement. Multiplied over55,000 retail pharmacies, that results in amore than $1-billion unfunded mandateon American community pharmacies.
TheCoalition for CommunityPharmacy Action (CCPA) is analliance between the NationalAssociation of Chain Drug Stores(NACDS) and the NationalCommunity PharmacistsAssociation (NCPA), whichtogether represents more than55,000 community pharmacies.CCPA leverages the support,effort, and infrastructure ofNACDS and NCPA while engagingcommunity pharmacy to participateand advocate on issuesaffecting the industry.
Unfortunately, mandating e-pedigreesand track-and-trace technologies is asolutionin search of a problem. Thereis no "crisis of counterfeit drugs" in theUnited States; both the FDA and theWorld Health Organization say prescriptiondrug counterfeiting in this country israre. We support steps to help strengthenthe alreadysafe prescription drugdeliverysystem and would eventuallylike to see a federal system. HR 5839,however, is the wrong answer.
It is our job to deliver this messageto Congress, but we need your help.Groups supporting the bill are workinghard to pick up cosponsors and gainmomentum. Lawmakers say their constituentsare clamoring for new supplychain safety measures. We need you tobecome a voice of health care authorityin your states and districts by calling andwriting your members of Congress andtelling them to oppose HR 5839.
It is an absolutely critical time for communitypharmacy. The coming monthsmay provide our best opportunity to geta permanent legislative fix for the AMPsystem and Medicaid reimbursements.Likewise, we have the chance to weighin with Congress on the safety of thedrug supply chain. As the most accessiblehealth care providers in the country,it is our responsibility to do so.