NCPA: Senate Bill Provides Medically Underserved Seniors Greater Access to Lower Drug Copays

May 5, 2015

The legislation would empower more seniors to choose the pharmacy that best fits their needs.

PRESS RELEASE

ALEXANDRIA, Va. (May 5, 2015) — The National Community Pharmacists Association (NCPA) strongly endorses The Ensuring Seniors Access to Local Pharmacies Act, S. 1190, which was introduced today by Senators Shelly Moore Capito (R-W.Va.), Joe Manchin (D-W.Va.), Tom Cotton (R-Ark.) and Sherrod Brown (D-Ohio). By expanding the number of pharmacies that may be able to offer discounted copays for Medicare Part D prescription drugs, the legislation would empower more seniors to choose the pharmacy that best fits their needs.

Medicare beneficiaries in medically underserved areas would be able to access lower copays at “any willing pharmacy” that agrees to accept a drug plan’s “preferred pharmacy” terms and conditions. S. 1190 is a companion bill to H.R. 793, The Ensuring Seniors Access to Local Pharmacies Act, which has been introduced by Reps. Morgan Griffin (R-Va.) and Peter Welch (D-Vt.).

“We now have a bipartisan, bicameral solution to the conundrum many seniors face when they sign up for Medicare Part D preferred pharmacy plans before realizing their pharmacy of choice cannot offer the advertised copays,” said NCPA CEO B. Douglas Hoey, RPh, MBA. “Medicare beneficiaries should not be confronted with the Hobson’s choice of continuing to patronize their pharmacy at a higher cost or making a long trip to another pharmacy. We commend these Senators for their leadership on this issue and strongly support this legislation which, if enacted, would benefit seniors the most.”

The support for S. 1190 extends to senior, patient and health advocacy groups that share common interests in finding practical ways of making Americans healthier. The Alliance for Retired Americans, the Center for Medicare Advocacy, Families USA, Justice in Aging, the Medicare Rights Center, the National Consumers League, the National Rural Health Association, and the U.S. Pain Foundation have already endorsed S. 1190.

Today many Medicare beneficiaries are effectively told by drug plan middlemen which pharmacy to use based on exclusionary arrangements between pharmacy benefit manager (PBM) middlemen and, in most instances, large publicly traded chain pharmacies.

S. 1190 is especially beneficial for seniors in underserved urban and rural communities who rely on independent community pharmacies. According to a recent Medicare study, in urban areas more than half of “preferred” pharmacy drug plans (54 percent) failed to meet the government's threshold for reasonable access to pharmacies. In rural America the closest “preferred” pharmacy can be 20 miles or more away.

Medicare officials have concluded that allowing any willing pharmacy to serve as a “preferred” pharmacy is “the best way to encourage price competition and lower costs in the Part D program.” Moreover, a leading health care economist has demonstrated how allowing the participation of “any willing pharmacy” as a “preferred pharmacy” can actually lower Medicare costs by increasing competition.

“There is no legitimate reason why S.1190 and H.R. 793 should not be passed in both chambers of the 114th U.S. Congress. We urge members to act,” Hoey added.

An online video produced by NCPA further explains this issue and also provides insights from community pharmacists describing the patient confusion and disruption in care resulting from network restrictions.