GREAT NECK, N.Y. — Rep. Tom Suozzi (D., N.Y.) got an education on drug cost dynamics during a tour of oncology pharmacy Onco360 here with members of the National Association of Specialty Pharmacy (NASP).
Vice chairman of the Problem Solvers Caucus in the House of Representatives, Suozzi said he made the visit to learn more about what’s behind today’s soaring drug costs and, in particular, the impact on patients. The freshman congressman met with Sheila Arquette, executive director of NASP; Paul Jardina, president and chief executive officer of Onco360, an independent specialty pharmacy serving cancer patients; and Timothy Ward, president of distributor Hercules Pharmaceuticals, which serves the independent and community pharmacy sector.
“We’re all concerned about affordability for consumers, and this was an opportunity to support some of the independent and smaller operators in the country,” Suozzi said in an interview.
Given the myriad factors influencing high drug pricing, the issue is perplexing not just to consumers and industry stakeholders but also to Congress, the lawmaker acknowledged.
“It’s incredibly complex. I don’t think people do understand how complicated it is. If it was easy, someone would have solved it already,” Suozzi said. “We need to have more of a considered, deliberative process where Democrats and Republicans work together to get input from experts to drill down to the real answers to these problems, as opposed to just trying to find someone to blame all the time, which is happening much too often in our country.”
In October, Suozzi was one of 54 members of Congress to sign a nonpartisan letter to the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) to ensure that rebates and discounts in Medicare Part D help rein in escalating out-of-pocket drug costs for patients.
Also in the letter, lawmakers urged HHS and CMS to uphold specialty pharmacy choice for patients and prescribers and address rising direct and indirect remuneration (DIR) fees from pharmacy benefit managers. They also cited misapplied Part D performance metrics, which align with Star Rating measures instead of the complex diseases treated by prescribed specialty drugs.
“The purpose of congressman Suozzi’s visit is to allow him to tour Onco360 and get a firsthand experience of what happens at a specialty pharmacy and how it’s different from other pharmacy practice settings — all of the high-touch, coordinated patient care that accompanies the dispensing of the medications to the patient,” NASP’s Arquette said.
“We also wanted to thank the congressman for his support in signing the letter, which asked HHS and CMS to look at some of the business practices of the PBMs with respect to DIR fees and ‘any willing pharmacy’ provisions, things that are negatively impacting specialty pharmacies’ ability to service Medicare patients,” she added.
Specialty medications’ share of U.S. drug spending rose from 23.6% in 2007 to 42.9% in 2016, NASP reported, citing QuintilesIMS data. In the discussion at the Onco360 tour, it was estimated that specialty’s share of drug expenditures will top 50% in the next few years, if not sooner.
“We’re trying to educate legislators across the country about specialty pharmacy and what it takes to accept an order from a physician for a specialty pharmaceutical and get it all the way through to fulfillment and support the patient moving forward — an appreciation for the level of work it takes to provide great care,” Onco360’s Jardina said.