May 21, 2013 (Arlington, Va.) — In written statements submitted for U.S. Senate and House of Representatives committee hearings this week, the National Association of Chain Drug Stores (NACDS) noted the essential role of community pharmacy in the success of the ten-year-old Medicare Part D prescription drug program, and urged program enhancements focused on the quality and affordability of care.
NACDS issued a statement for today’s hearing of the House Committee on Ways and Means Subcommittee on Health, titled “The President’s and Other Bipartisan Proposals to Reform Medicare.” NACDS also will provide a similar statement for Wednesday’s hearing of the Senate Special Committee on Aging, titled “10 Years Later: A Look at the Medicare Prescription Drug Program.”
“As the face of neighborhood healthcare, community pharmacies and pharmacists provide access to prescription medications and over the counter products, as well as cost-effective health services such as immunizations and disease screenings,” NACDS wrote. “Through personal interactions with patients, face-to-face consultations and convenient access to preventive care services, local pharmacists are helping to shape the healthcare delivery system of tomorrow — in partnership with doctors, nurses and others.”
NACDS commended Congress for including medication therapy management (MTM) in Medicare Part D at its inception, and urged the advancement of legislation to improve this methodical approach to helping patients take medications safely and as prescribed. NACDS advocated for the Medication Therapy Management Empowerment Act of 2013 — H.R. 1024 in the House and S. 557 in the Senate – which would open MTM to Medicare Part D beneficiaries who suffer from one, rather than multiple, chronic diseases.
NACDS described a study published in the January 2012 edition of Health Affairs, which identified the key role of retail pharmacies in providing MTM services. The study found that a pharmacy-based intervention program increased patient adherence for patients with diabetes and that the benefits were greater for those who received counseling in a retail, face-to-face setting as opposed to a phone call from a mail order pharmacist.
NACDS also emphasized that the Congressional Budget Office in late 2012 announced steps to reflect in its cost-evaluation of legislative proposals the belief that better use of medications can generate savings by reducing reliance on costly forms of care. If generalized to the nation as a whole, just a one-percent increase in medication use saves $1.7 billion in overall healthcare costs, or $5.76 per person. Also, the Centers for Medicare & Medicaid Services in February 2013 released a study focused on Medicare beneficiaries with certain lung or heart conditions. Those enrolled in medication therapy management services in 2010 — and particularly those who received comprehensive medication reviews – experienced significant improvement in the quality of their drug regimens and costs were saved.
NACDS urged steps to incorporate the value of community pharmacy into emerging care models, such as accountable care organizations (ACOs).
“Permitting pharmacists to practice to their maximum capabilities within these new delivery models would help increase medication adherence and coordination between healthcare settings, result in higher rates of vaccinations, and reduce the burden of the physician shortage, particularly with the influx of new patients in 2014 through the Healthcare Marketplaces and the expansion of Medicaid eligibility,” NACDS wrote. “As we move forward with the reform of the healthcare delivery system and improving Medicare, it is imperative for all healthcare providers to practice to their maximum capabilities, working in partnership to provide accessible, high quality care to patients.”
NACDS also urged caution related to the growing role of preferred pharmacy networks in Medicare Part D.
“NACDS believes the choice of where to obtain prescription drugs and pharmacy services should be left to Medicare beneficiaries. In order to make an informed choice, it is important for beneficiaries to have clear information,” NACDS said.
“We applaud efforts by CMS to ensure beneficiaries are fully educated when making plan selections and do not make selections based on ambiguous information. NACDS recommends that all beneficiaries be given clear instructions that, regardless of plan selection, they still retain the right to have a prescription filled at the pharmacy of their choosing and are not required to obtain their prescriptions at a preferred network. Ensuring beneficiary awareness of this policy will lead to less confusion and will allow beneficiaries to continue to utilize the pharmacy of their choice.
“While beneficiary cost sharing may encourage the use of a preferred pharmacy, it should not be so significant as to disadvantage Medicare beneficiaries who rely on a pharmacy not in the preferred network. This may be particularly important in rural and urban areas, where beneficiaries would have to travel long distances to access preferred network pharmacies.”