The 2022 NACDS Total Store Expo (TSE) will serve as an accelerator toward the 90th anniversary of NACDS, which we will commemorate together in 2023.

Steven Anderson

NACDS TSE serves as the ideal platform. It brings together retailers and suppliers with responsibility for diverse products and services throughout the entire store and beyond.

I look forward to the energy, the buzz, the collaboration, the productivity and the exhilaration of business being accomplished — and ultimately customers being well served — at this year’s NACDS TSE.

In addition, this year’s event provides an ideal opportunity to assess the public policy arena in which NACDS competes to empower forward-thinking solutions for the industry, for patients and for consumers.

This assessment is best viewed through the lens of the tagline that has long captured the agenda determined by the NACDS board of directors: “Pharmacies. The face of neighborhood healthcare.”

That tagline rings as true today as it did when we created it 15 years ago. Yet executing on it demands constant calibration, dedication and resolve.

NACDS believes it is vividly clear that living up to the singular focus of pharmacy’s calling as the face of neighborhood health care requires, ­simultaneously:

• Advancement of valuable pharmacy services.
• Efforts to help ensure fair and viable pharmacy ­reimbursement.
• Leveraging the full array of health and wellness opportunities made possible throughout the pharmacy, the entire store and the complete relationship with the consumer.

For the advancement of a truly pro-pharmacy and pro-patient agenda, these pursuits are indivisible. And NACDS is waging them with boundless vigor at a most unique time.

Advancing pharmacy services

America entered a stage of “COVID-19 fatigue” some time ago. Many feel it is time to move on. Yet there is danger in policy makers’ misinterpreting those sentiments as a free pass to not take action for sustained preparedness.

In fact, a Morning Consult poll commissioned by NACDS found that 70% of Americans support extending the federal policies put into place to allow pharmacists and pharmacy teams to provide pandemic-related services — and 68% support making them permanent. Among those who received a COVID-19 vaccine booster at a pharmacy, those percentages hit the mid-80s.

To enhance patient access and health equity, NACDS is working with allies to make permanent at the state level the pharmacy flexibilities of the federal Public Readiness and Emergency Preparedness Act (PREP Act); to extend the temporary federal flexibilities through October 2024; and to establish reliable Medicare Part B reimbursement pathways through federal legislation — H.R. 7213, the Equitable Community Access to Pharmacist Services Act.

As I write this, Pennsylvania has just delivered the most recent progress in making permanent and positive change at the state level. Gov. Tom Wolf (a Democrat) signed patient-access legislation to allow pharmacists and pharmacy interns to administer COVID-19 and flu vaccines to children down to the age of 5. Currently, the only vaccine that pharmacists can administer to children is influenza — and only to those 9 years of age and older.

Regarding the extension of the full array of pharmacy flexibilities at the federal level, NACDS continues to urge action by the Biden administration. The emergence of yet another COVID-19 strain shows the importance of doing so.

Also at the federal level, NACDS is working with the Future of Pharmacy Care Coalition to advance H.R. 7213. This legislation would provide a reliable reimbursement pathway for vaccinations, testing and treatment in the pharmacy for COVID-19 and for selected other illnesses. I encourage all retailers and suppliers to advocate for this bill.

Fair and viable reimbursement

NACDS remains intent on confronting unworkable pharmacy reimbursement schemes — and there are many.

Of course, there are reimbursement issues involving misguided state and federal policies. NACDS, the Washington State Pharmacy Association and the National Community Pharmacists Association achieved a late-breaking victory in June on one such issue. Capping many years of federal and state advocacy in capitals and in the courts, the federal Centers for Medicare and Medicaid Services (CMS) officially disapproved Washington State’s unreasonably and unlawfully low Medicaid reimbursement.

Yet, there also are reimbursement threats from pharmacy benefit managers, which squeeze patients and pharmacies alike. It is gratifying to see the long-standing work to confront PBM tactics meeting with more and more recognition and more and more results.

The Supreme Court’s unanimous ruling in the 2020 Rutledge v. Pharmacy Care Management Association decision opened the door to hundreds of state bills to regulate PBMs. NACDS submitted an amicus brief for the Supreme Court’s consideration, and is advocating for the legislation flowing from the court’s decision.

In addition, the Federal Trade Commission in June of this year voted unanimously to launch an investigation of PBM practices. The FTC stated: “[PBMs] often have enormous influence on which drugs are prescribed to patients, which pharmacies patients can use and how much patients ultimately pay at the pharmacy counter. Many of these functions depend on highly complicated, opaque contractual relationships that are difficult or impossible to understand for patients and independent businesses across the prescription drug system.” NACDS provided compelling comments to the FTC, and will remain active on this issue.

In another example of PBM reform’s traction, just days prior to my drafting of this article, Florida Gov. Ron DeSantis (a Republican) issued an executive order “to drive transparency in prescription costs for Floridians.” This action directs state agencies to work into PBM contracts prohibitions on spread pricing and reimbursement clawbacks, and requirements for data transparency and reporting — including a review of all rebates, payments and relationships between pharmacies, insurers and ­manufacturers.

In addition, NACDS and our allies are working for new federal regulations and legislation to build on a new direct and indirect remuneration (DIR) fee transparency rule issued by the federal CMS earlier this year. This is important work on dire and exorbitant fees that have hit patients and pharmacies hard for a decade.

NACDS 2023

Beyond advancing pharmacy services and protecting pharmacy reimbursement, I am extremely enthusiastic about the new NACDS 2023 initiative. It reflects NACDS members’ important work to advance health and wellness in new and creative ways in the pharmacy and beyond.

In one example, NACDS earlier this year backed the Medical Nutrition Therapy Act (S. 1536/H.R. 3108) — introduced in Congress. It reflects NACDS’ commitment to a holistic and multidisciplinary approach to health, wellness and equity. It would enhance the availability of medical nutrition therapy delivered by registered dietitians, including those practicing in the retail setting. NACDS also is urging for pharmacists to be able to refer their patients for this therapy.

NACDS also is engaging strongly in the White House Conference on Hunger, Nutrition and Health, to be held in September, as well as in the Biden administration’s national strategy on these issues. In June and July, NACDS led valuable listening sessions with chain and supplier members to develop recommendations for the administration.

NACDS’ five key recommendations include: expanding eligibility for the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC); enhancing opportunities for pharmacists and pharmacies to participate in existing national prevention programs for conditions including diabetes (Medicare Diabetes Prevention Program) and cardiovascular disease (Million Hearts Initiative); incentivizing payors to cover health and wellness programs to support better public access to health care professionals such as dietitians and pharmacists who can provide preventive and management support for related conditions; passage of the Equitable Community Access to Pharmacist Services Act; and scope of practice expansion for pharmacists and other health care professionals that can move the needle on hunger, nutrition and health, including point-of-care testing to inform disease prevention and management efforts, such as A1c.

Thank you to the vibrant NACDS retailer and supplier membership. It is an honor for NACDS to serve as the collective and collaborative will of the membership, which is accomplishing so much for the American people.

Steve Anderson is president and chief executive officer of the National Association of Chain Drug Stores.