NCPA Offers Constructive Solutions to Potentially Problematic Pharmaceutical Waste Reduction Efforts in Long-Term Care Dispensing

Alexandria, VA - June 21, 2010


The National Community Pharmacists Association (NCPA) has sent a letter to the Centers for Medicare and Medicaid Services (CMS) providing four recommendations regarding the upcoming implementation of Section 3310 of the Patient Protection and Affordable Care Act (health care reform bill). The law changes the monthly dispensing cycle of prescription drugs to long-term care facilities in an effort to reduce pharmaceutical waste. However the shift comes with financial and logistical hardships, particularly for independent pharmacies, that must be resolved. NCPA's letter offered the following recommendations:

  • Conduct a scientific study of the actual benefits of reducing dispensing cycles from a monthly to weekly basis, since NCPA contends pharmacies already incorporate numerous strategies to deal with unused prescription drugs that are paid for under Medicare Part D; and/or utilize an interim stage of reducing the dispensing window to every 14 days to ascertain its impact before moving forward with a tighter window, such as a seven-day cycle or less.

  • Allocate greater, timely financial compensation to help pharmacies adjust to the need to account for the extra dispensing cycles, which may entail, for example, hiring more staff or investing in additional technology.

  • Create an exemption for small pharmacies (those meeting the Small Business Administration's definition as having revenues of $7 million or less) and those in rural areas that will likely lack the incentives or capital to continue providing long-term care services.

  • Allow for a two-year transition for these changes to occur from January 1, 2012 until January 1, 2014 instead of having the earlier date be the line of demarcation for full compliance, so pharmacies can effectively implement the changes without too much disruption to their long-term care services.

"Pharmacists share the important goal of reducing pharmaceutical waste," said Bruce T. Roberts, RPh, NCPA executive vice president and CEO. "But CMS must address the real concerns independent community pharmacies have with proposed long-term care prescription drug dispensing changes. Without examining how effective more frequent dispensing will be, providing more resources in a prompt fashion, creating a workable transition time period, and exempting smaller and rural independent community pharmacies, the change will likely be very disruptive. This is an example where the law of unintended consequences can be anticipated well in advance. We hope CMS is prudent in the policy that is implemented."

"Approximately 7,000 independent community pharmacies service the long-term care market, but without a more common-sense approach to limiting pharmaceutical waste their participation levels might have to drop in order to maintain financial viability," added Roberts.

The National Community Pharmacists Association (NCPA®) represents America's community pharmacists, including the owners of more than 22,700 independent community pharmacies, pharmacy franchises, and chains. Together they represent an $88 billion health-care marketplace, employ over 65,000 pharmacists, and dispense over 40% of all retail prescriptions. To learn more go to or read NCPA's blog, The Dose, at

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