ALEXANDRIA, Va. — The National Community Pharmacists Association supports legislation reintroduced by Reps. Peter Welch (D, Vt.) and Morgan Griffith (R, Va.) that would give seniors more convenient access to discounted or “preferred” copays for prescription drugs at their pharmacy of choice. The Ensuring Seniors Access to Local Pharmacies Act (H.R. 2608) would also empower more seniors to choose the pharmacy that best fits their needs; promote transparency so that pharmacies have clear understanding of their reimbursement; and tackle conflicts of interest that exist with patient steering by pharmacy benefit managers to pharmacies affiliated with the PBM.
The legislation is among NCPA’s advocacy priorities during its annual NCPA Congressional Pharmacy Fly-In, which will be taking place virtually April 19-21.
NCPA CEO B. Douglas Hoey said, “Patients deserve easier access to affordable, quality, and convenient care at the pharmacy of their choosing, without PBM roadblocks that our health care system currently tolerates. Independent pharmacies have never been more essential to their communities than during the pandemic as they help save lives by administering coronavirus vaccines and testing, and also providing curbside and delivery service to safely supply their patients with the medicines they need. Without reforms and relief from PBM practices, however, these small businesses may not survive to provide needed care into the future. Independent pharmacy is grateful to Reps. Welch and Griffith for continuing their push to remove some of these obstacles, improve our health care system, and increase choice for patients and transparency into PBM tactics.”
The Ensuring Seniors Access to Local Pharmacies Act would allow seniors in medically underserved areas to access lower copays at any pharmacy willing to accept the Medicare Part D drug plan’s “preferred pharmacy” terms and conditions (i.e., pricing). Currently, pharmacy benefit managers are effectively telling many Medicare beneficiaries which pharmacy to use based on exclusionary arrangements between PBMs and, for the most part, big-box pharmacies, oftentimes ones the PBM has an ownership interest in. Independent community pharmacies are excluded from such arrangements, despite playing a large role in caring for medically underserved populations. The result is that seniors in many rural and urban communities often face either higher copays; lengthier trips to a “preferred” pharmacy, likely passing many excluded community pharmacies along the way; or being forced to use mail order, which simply doesn’t work for a lot of seniors. A recent consumer survey found that a large majority of American adults prefer to get their prescription drugs from a local pharmacist instead of a mail order service, mainly because of the personal relationship.
In addition, the Ensuring Seniors Access to Local Pharmacies Act would require claims level reimbursement transparency so pharmacies have a clearer understanding of their reimbursement. It also includes language to prevent PBMs from reimbursing their affiliated pharmacies more than they do other pharmacies and to ensure reimbursement covers acquisition and dispensing costs, helping to establish a level playing field among all pharmacies.
Original cosponsors of the Ensuring Seniors Access to Local Pharmacies Act include Reps. Rick Allen (R, Ga.), Cindy Axne (D, Iowa), Buddy Carter (R, Ga.), Rick Crawford (R, Ark.), Vicente Gonzalez (D, Texas), Dutch Ruppersberger (D, Md.), and Bruce Westerman (R, Ark.).