ALEXANDRIA, Va. (Mar. 12, 2014) — The National Community Pharmacists Association (NCPA) is urging Iowa Gov. Terry Branstad (R) to sign into law H.F. 2297, legislation that could potentially offer the state’s small business community pharmacies modest relief from being reimbursed at a financial loss as pharmacy acquisition costs for scores of generic drugs are skyrocketing by as much as 600%, 1,000% or more.
Currently, independent pharmacies must evaluate take-it-or-leave-it contract offers from pharmacy benefit managers (PBMs) on behalf of health insurance plans. The “black box” of pharmacy reimbursement is a PBM’s “maximum allowable cost” or MAC. Pharmacists are left in the dark as to how reimbursement caps, or MACs, are determined for many common generic medications, which comprise about 80 percent of drugs pharmacies dispense.
“H.F. 2297 would give independent community pharmacists some basic insights into their reimbursement from PBMs for common generic drugs, as well as set forth an appeals process to hopefully resolve differences that may emerge if PBMs continue to reimburse community pharmacies at lower, outdated rates when in fact drug acquisition costs increase significantly for pharmacies,” said NCPA CEO B. Douglas Hoey, RPh, MBA. “We encourage Gov. Branstad to sign this legislation into law. NCPA is proud to support the efforts of Iowa’s independent community pharmacies on this issue.”
Iowa is home to more than 300 independent community pharmacies which employ an estimated 3,400 residents full-time. Six other states have enacted MAC legislation during the past two years and 12 other states are actively considering such proposals.
Click here to view a copy of NCPA’s letter.