NACDS Takes to Congress Concerns about Administration's Budget


Urges consistent policies that improve patient health and affordability of care in Medicaid, Medicare, TRICARE.


April 17, 2013 (Arlington, Va.) — Urging consistent government policies that empower the benefits of pharmacy patient care, the National Association of Chain Drug Stores (NACDS) today submitted statements in conjunction with Congressional committee hearings focusing on the Obama Administration’s FY2014 budget proposal.

NACDS weighed in today with statements to the U.S. Senate Committee on Finance and to the U.S. Senate Committee on Armed Services, and prepared to submit a statement for Thursday’s hearing of the U.S. House of Representatives Committee on Energy and Commerce.

In its statements, NACDS emphasized that community pharmacies help patients use medicines safely and stay healthy, and that innovative pharmacy services do even more to improve patient health, quality of life and healthcare affordability. NACDS urged consideration of budget provisions to ensure that public policy leverages the value of trusted and accessible pharmacists, who are extremely valued by those in greatest need.

NACDS reminded the committees that a Centers for Medicare & Medicaid Services (CMS) study released earlier this year found positive results from medication therapy management (MTM) — a methodical approach to improving medication use to improve patient health. In the study, Medicare patients with specific lung and heart conditions who were enrolled in the Part D MTM program met with better outcomes than those not participating in MTM, and prescription drug and hospitalization costs were lower for MTM participants. NACDS also noted the results of a study published in the January 2012 Health Affairs that community pharmacy-based MTM produced better results than phone calls from mail-order pharmacists.

To the Senate Finance Committee, NACDS expressed concern about a proposed change to the method of calculating Medicaid federal upper limits (FULs) for pharmacy reimbursement through the average manufacturer price (AMP) model. NACDS noted that efforts are underway to implement the AMP provisions of the Affordable Care Act, and that changes outside of this process are premature.

“We urge CMS to utilize the rulemaking process to implement the Medicaid pharmacy provisions in a manner consistent with Congressional intent, rather than pursuing policies that would further cut pharmacy reimbursement,” NACDS said.

NACDS’ statement to the Senate Finance Committee also provided advice on proposals to cut waste, fraud and abuse in Medicare and Medicaid; applauded proposals to increase generic drug utilization; and took issue with a proposal to limit Medicaid reimbursement of durable medical equipment (DME) to rates paid by Medicare, noting that this step “has the potential to disrupt access to DME and produce poorer health outcomes ,” and that this is “particularly true in the case of diabetes testing supplies (DTS).”

To the Senate Armed Services Committee, NACDS noted the success — in patient health and in cost-savings – of the retail pharmacy vaccination program for TRICARE beneficiaries, including military families and veterans.

“DoD [The Department of Defense] estimated that in the first six months of the immunization program, it had saved over $1.5 million by having vaccinations provided through the pharmacy rather than the medical benefit,” NACDS said, adding that this estimate did not take into consideration the avoidance of costs for treating influenza and other illnesses that would have been likely had the beneficiaries not been vaccinated.

Given the ability of community pharmacies to help reduce costs through improved adherence to medication therapies, NACDS cautioned that it would be “penny wise and pound foolish” to implement an Administration proposal that would make further changes to pharmacy co-payments and other policies that would drive TRICARE beneficiaries out of their local pharmacies and to the TRICARE Mail Order Pharmacy.

“NACDS supports cost savings initiatives that preserve patient choice,” NACDS said. “For example, the utilization of generic medications by TRICARE beneficiaries is low in comparison with other plans. The generic dispensing rate at retail pharmacies — 78 percent in 2012 – is higher than any other practice setting. Partnering with local pharmacists, modest increases in generic utilization by TRICARE beneficiaries would have a dramatic impact on the DoD budget.”

NACDS’ statements in conjunction with the Congressional committee hearings follow its immediate joint letter to CMS with the National Community Pharmacists Association that communicate immediate concerns with aspects of the Administration’s budget proposal.

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