Pharmacists Praise House Passage of North Dakota Bill to Bring Transparency to Drug Reimbursement



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Alexandria, Va. March 6, 2013 - The National Community Pharmacists Association (NCPA) joins with the North Dakota Pharmacy Association (NDPhA) in commending the state assembly for its overwhelming passage of H.B. 1363. The North Dakota House of Representatives favorably moved on H.B.1363 with a vote of 93-0. This common sense, bipartisan legislation provides greater contract transparency for pharmacies with billion-dollar corporations known as pharmacy benefit managers (PBMs) by requiring certain terms be disclosed up front.

Specifically, H.B. 1363 would:

  • Support North Dakota small business community pharmacies by requiring PBMs simply to notify pharmacies how reimbursement for most prescription drugs would be calculated. Unfortunately, pharmacies are kept in the dark about how PBMs determine these reimbursement limits, known as maximum allowable costs (MACs).
  • Implement fairer business practices by providing an appeals process for pharmacies to contest MAC assertions by PBMs.

"For too long pharmacies have been forced into one-sided contracts that compel pharmacies to either accept the PBMs' MACs or forego serving their patients," said Mike Schwab, NDPhA Executive Vice President. "This legislation is a step in the right direction to ensure PBMs disclose how pharmacies will be reimbursed for generic drugs in contracts. I am pleased that North Dakota is leading the way on this front."

NCPA CEO B. Douglas Hoey, RPh, MBA added, "We appreciate Mike's leadership in getting this legislation through the House and are extremely proud to have been closely involved and supported the state association's efforts. We encourage the North Dakota Senate to quickly follow suit and pass this bill so it can be signed by the Governor. This legislation provides reasonable transparency, sets standards for how determinations are made to put medications on a MAC list, and provides a real appeals process for pharmacies to contest a listed MAC price. For independent community pharmacy, clear information on generic reimbursements is vital. Community pharmacies dispense generic alternatives with greater frequency than their mail order counterparts, which saves money for both patients and plan sponsors."

This legislation now heads to the North Dakota State Senate. Similar MAC transparency legislation is currently being considered in Maryland, Georgia and Kentucky.

In North Dakota there are over 199 independent community pharmacies, according to data from the North Dakota Board of Pharmacy. These pharmacies provide an estimated 2,109 jobs, according to NCPA, and contribute greatly to local and state tax revenue.

The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies. Together they represent an $88.5 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 300,000 individuals, including over 62,000 pharmacists. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com/.

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