Alexandria, Va. - April 4, 2012
Some independent community pharmacies could be forced to leave the Medicaid program or close altogether unless federal officials make changes to a proposed regulation relating to the calculation of Medicaid generic reimbursements using the average manufacturer price (AMP) of prescription drugs, the National Community Pharmacists Association (NCPA) said in comments recently submitted to the Centers for Medicare & Medicaid Services (CMS).
"Independent community pharmacies are the backbone of the Medicaid drug benefit. They provide cost-saving medication counseling, assist patients in underserved rural and inner-city areas, and rely on prescriptions for over 90 percent of their revenue," said NCPA CEO B. Douglas Hoey, RPh, MBA. "Inadequate reimbursement could threaten patient access to prescription drugs by forcing community pharmacies out of the Medicaid program. Ultimately, that would only raise health care costs as patients seek more expensive forms of medical care."
The AMP data covered in CMS' proposed regulation is used by the agency to set new federal upper limits (FULs) for common generic drugs in Medicaid. Based on flawed, previous AMP data collected from drug manufacturers, CMS has published seven proposed FULs lists, many of which would reimburse pharmacies below their drug acquisition costs.
In comments submitted to CMS, NCPA made the following points, among others:
Earlier this year, 25 members of the Senate Finance and House Energy and Commerce committees wrote to CMS to highlight many of the concerns NCPA has expressed regarding insufficient, proposed FULs calculated from AMP data for Medicaid generic drug reimbursement.
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 a $93 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 315,000 people, including 62,400 pharmacists. Independent community pharmacists are readily accessible medication experts who can help lower health care spending. They are committed to maximizing the appropriate use of lower-cost generic drugs and reducing the estimated $290 billion that is wasted annually by improper medication use. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.
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