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The Dose

Turn Up the Heat on Congress this Summer

by Michael Rule | Jul 29, 2016

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Congress recently departed Washington, DC for its annual summer recess. This year their break is two weeks longer than usual due to the scheduling of the party conventions. While many members of Congress were celebrating the official nomination of their party’s candidates for President and Vice President, many independent pharmacies were receiving official notifications from pharmacy benefit managers (PBMs) of direct and indirect remuneration (DIR) fees that were nothing to celebrate over.

NCPA has received reports that one large PBM is assessing DIRs for prescriptions filled in the first quarter of 2016-as far back as January. Some have reported that these fees are as high as $30,000 for just one quarter. The outrageous sum and lag time makes it nearly impossible for small business pharmacies to make business decisions for the future, and is unsustainable for any business. Understandably, many independent pharmacists are frustrated.

Fortunately, there is a constructive way to focus that frustration. With Congress away from Washington until Labor Day, many members are spending extra time in their districts meeting with constituents. This is an ideal time to invite your legislator to tour your pharmacy to get a first-hand look at the services you provide and respectfully discuss some of these issues with them face to face and explain the impact these fees have on your business and your community, and urge your legislator to take action to help resolve the issue. For example, are DIRs affecting your ability to maintain your employment levels or sustain your charitable donations? Such details help localize the issue for your legislator. You should ask them to send a letter to the Centers for Medicare & Medicaid Services (CMS) similar to the ones 16 Senators and 30 members of the House of Representatives sent the agency asking them to finalize proposed guidance on DIRs that would require plans to approximate most of these fees at the point of sale, .

Hosting a pharmacy visit is an effective way to make a lasting impression on your legislator, Tips for scheduling a pharmacy visit with your member of Congress can be found here (NCPA login required), click here for a sample letter you can customize to invite your member of Congress to tour your pharmacy, or you can contact Michael Rule at for more information.

While a visit to your pharmacy is ideal, there may be other opportunities to engage your legislators face to face. Some may host town hall meetings to discuss a variety of issues with constituents. If one is scheduled in your area, consider attending and asking a question about DIR fees are generic drug pricing transparency.

If you are unable to discuss issues with your legislators in person, it is still important that you engage them during this period, and encourage your patients to do the same. NCPA has created a grassroots toolkit that includes a sample letter to the editor, news release, bag stuffer and social media posts that you can access here to assist with your outreach, and you can visit the NCPA Legislative Action Center to send messages to your legislators on specific issues.

Use this recess period to remind your legislators that while they may be away from Washington; the need to address issues such as DIRs remains critical.