NCPA Addresses "Lock-In" Pharmacy Legislation

The National Community Pharmacists Association has written lawmakers to provide pharmacists' feedback and recommendations to improve so-called "lock-in pharmacy" provisions within H.R. 1021.


ALEXANDRIA, Va. (Feb. 26, 2015) — In advance of a committee vote regarding Medicare legislation, the National Community Pharmacists Association (NCPA) has written lawmakers to provide pharmacists’ feedback and recommendations to improve the measure. (To download the letter, click here.)

The House Ways & Means Committee has scheduled a vote today on H.R. 1021. NCPA’s comments focused on so-called “lock-in pharmacy” provisions within H.R. 1021 that would restrict the ability of Medicare beneficiaries to obtain prescribed narcotic painkillers if the patients are deemed to be at “high risk” of prescription drug abuse.

“Lock-in pharmacy initiatives in state Medicaid programs virtually always include the ‘lock-in’ of both prescriber and pharmacy because a coordinated approach to patient care is essential to the success of any such program,” said NCPA CEO B. Douglas Hoey, RPh, MBA. “The committee’s proposal to require the ‘lock-in’ of both a prescriber and a pharmacy is an improvement compared to proposals that overlook prescribing. The prescription drug abuse epidemic is complex and wide-ranging in nature and at the forefront of prevention efforts must be a focus on reducing the inappropriate prescribing.”

NCPA has serious concerns about granting plan sponsors unilateral authority to require certain Medicare beneficiaries to use a particular pharmacy for their prescribed controlled substances, because drug plan sponsors may simply assign beneficiaries to pharmacies that the sponsor owns or in which it has a financial interest. Already Part D plans exclude independent community pharmacies from many “preferred” pharmacy networks.

NCPA’s letter offered lawmakers specific proposals, including the following, to further safeguard timely access to controlled substances for patients with legitimate medical needs.

  • Strengthen beneficiary protections to help prevent the mandated use of pharmacies owned by or affiliated with the drug plan sponsor.
  • Clarify exempted individuals to include patients in long-term care settings and those suffering intractable pain, such as due to an advanced cancer diagnosis.
  • Greater use of existing authorities already available to combat prescription drug abuse.