The National Association of Chain Drug Stores has called on Congress to assess key pharmacy provisions in the Obama administration's 2015 federal budget proposal.

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NACDS highlights role of pharmacy in 2015 U.S. budget

March 12th, 2014

ARLINGTON, Va. – The National Association of Chain Drug Stores has called on Congress to assess key pharmacy provisions in the Obama administration's 2015 federal budget proposal.

NACDS said Wednesday that it has submitted a statement to the House budget and ways and means committees as they start reviewing the fiscal 2015 budget in hearings this week. The Obama administration released its 2015 budget proposal last week.

"Community pharmacies and pharmacists provide access to prescription medications and over-the-counter products, as well as cost-effective health services such as immunizations and disease screenings," NACDS said in its statement to lawmakers. "Through personal interactions with patients, face-to-face consultations and convenient access to preventive care services, local pharmacists are helping to shape the health care delivery system of tomorrow, in partnership with doctors, nurses and others."

NACDS cited public and private studies illustrating the health benefits and savings from pharmacist-provided medication therapy management (MTM) services, including a 2013 report by the Centers for Medicare & Medicaid Services (CMS) showing that Medicare Part D MTM programs improved medication adherence and the quality of prescribing for evidence-based medications for seniors with congestive heart failure, chronic obstructive pulmonary disease (COPD) and diabetes.

"Policymakers have begun to recognize the vital role that local pharmacists can play in improving medication adherence," NACDS stated. "Congress has recognized the importance of pharmacist-provided services such as MTM by including it as a required offering in the Medicare Part D program."

Referring to pharmacists' clinical capabilities in prescription drug and other health services, the association also urged the "implementation of budget proposals that allow all health care providers, including retail pharmacists, to practice to their maximum capabilities, working in partnership to provide accessible, high-quality care to patients."

NACDS expressed its opposition to the Department of Health and Human Services (HHS) proposal in the 2015 federal budget to exclude brand-name and authorized generic drugs from the calculation of average manufacturer price (AMP), which the association noted would result in the calculation of Medicaid Federal Upper Limits (FULs) based only on generic drug prices.

"While the goal of this provision may be to decrease Medicaid costs, we believe it may in fact reduce access to prescription drugs and pharmacy services for Medicaid patients, resulting in increased overall health care expenditures," NACDS pointed out.

About 35% of the draft FULs are below the National Average Drug Acquisition Cost (NADAC), according to recent analysis by NACDS.

"This analysis confirms that additional efforts by CMS are necessary to ensure that pharmacies are not reimbursed below their costs using the reimbursement formula created by the Affordable Care Act," the association said in its comments. "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."

Changes being considered by CMS to Medicaid reimbursement of durable medical equipment (DME), specifically for diabetes testing supplies (DTS), could also have a negative impact on patient care, NACDS said. "Reducing Medicaid reimbursement for DTS to match the Medicare rate could similarly produce hardships for Medicaid beneficiaries in terms of reducing access to needed supplies and threatening the health of an already fragile population," the association said in its statement.

NACDS, too, voiced its support for provisions to increase the utilization of generic drugs, which helps mitigate prescription drug costs, and HHS' efforts to reduce waste, fraud and abuse in Medicare and Medicaid in a way that doesn't impede access to care or  jeopardize beneficiaries' health.

"We look forward to working with policymakers and stakeholders on these important issues," NACDS concluded.