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NACDS gives take on 2014 U.S. budget proposal
April 18th, 2013
ARLINGTON, Va. – With congressional committee hearings now focusing on the Obama administration's 2014 budget proposal, the National Association of Chain Drug Stores reiterated to lawmakers the value that community pharmacy brings to the nation's health care system.
NACDS submitted statements for hearings on Wednesday by the Senate Committee on Finance and the Senate Committee on Armed Services and prepared to submit a statement for a hearing of the House of Representatives Committee on Energy and Commerce on Thursday.
In its remarks NACDS urged consideration of budget provisions to ensure that policy leverages the value of community pharmacists, who help patients use medicines safely, are easily accessible and provide a range of affordable health services that help improve outcomes and rein in medical costs.
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). In the research, Medicare patients with certain lung and heart conditions who were enrolled in the Medicare Part D MTM program had 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 issue of the journal Health Affairs that community pharmacy-based MTM yielded better results than phone calls from mail-order pharmacists.
To the Senate Finance Committee, NACDS expressed its 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. The association noted that efforts are under way 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 in its statement to the committee.
NACDS also gave the Finance Committee recommendations on ways to cut waste, fraud and abuse in Medicare and Medicaid and hailed proposals to boost generic drug utilization. The association, too, took issue with a proposal to limit Medicaid reimbursement of durable medical equipment (DME) to rates paid by Medicare, noting that such as 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."
In its comments to the Senate Armed Services Committee, NACDS cited the patient health beneifts and cost savings of the retail pharmacy vaccination program for TRICARE beneficiaries, including military families and veterans.
"DoD [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 stated, adding that its estimate didn't reflect the avoidance of costs for treating flu and other illnesses that may have arisen if the beneficiaries weren't vaccinated.
The association also warned that it would be "pennywise 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," the association stated. "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% 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."
Earlier this week, NACDS and the National Community Pharmacists Association sent a letter to CMS to voice their concerns about a proposal to reduce Medicaid drug reimbursement that was included in the Obama administration's 2014 budget.