NCPA Executive Update

NCPA Executive Update delivers insights on legislative, regulatory, policy, and industry developments from NCPA CEO B. Douglas Hoey, Pharmacist, MBA, to NCPA members and pharmacy leaders every Friday.

Talking and Acting | NCPA Executive Update | October 7, 2016

by NCPA | Oct 07, 2016

Dear Colleague,

Doug Hoey

October is both American Pharmacists Month and Talk About Your Medicines Month, and we encourage you to talk with your patients about safe and effective medication use. But conversations about prescription drugs lately are just as likely to be about their price as their efficacy or side effects.

From blockbuster disease-curers (Solvadi®) and proven life-savers (EpiPen® and naloxone) to long-ago released generics (tetracycline and many more), and from pharmacy counters and kitchen tables to Capitol Hill, drug prices and who is paying and profiting is being much debated. One area that is finally being examined in depth beyond the pharmaceutical world is the role of PBMs—the quintessential middlemen.

The so-called mainstream media this year is probing PBMs as never before. Lee Zurik of Fox 8-TV in New Orleans has broken a series of stories on patient copay clawbacks, DIRs, and other questionable PBM tactics. (Earlier this week, three patients filed a class action lawsuit against UnitedHealth Group over copay clawbacks.)

DIRs and clawbacks certainly will be a hot topic at the NCPA Annual Convention. Zurik will conduct a workshop on his investigative reports at the convention, Monday, Oct. 17. Also on the 17th, there will be a special presentation at the Second General Session on strategies for dealing with DIRs. Register for the convention online by 11:59 p.m. ET tonight to save $250 on registration rates. Prices increase starting Oct. 8.

Interestingly, recent PBM articles have started appearing more regularly in online and print publications closely read by stock traders, analysts, and investors—Business Insider, Forbes, and last Sunday The Wall Street Journal ("Drug Makers Point Finger at Middlemen for Rising Drug Prices").

Rep. Buddy Carter (R-Ga.) vividly captured the reality of PBMs recently in an op-ed in The Hill, when he wrote: "It's time to start paying attention to the man behind the curtain. In the drug pricing equation, that is the Pharmacy Benefit Manager or PBM."

His comment is inspired by "The Wizard Oz," of course, when the "wizard" is discovered to have no magical powers. Remind you of PBMs' claims of bringing down drug prices? And remember that when exposed, the wizard shouted, "Pay no attention to the man behind the curtain."

That won't be the possible if the House Oversight and Government Reform Committee agrees to NCPA's request hold a hearing on the role of PBMs in the increasing cost of prescription drugs. Carter serves on the committee and so does fellow Georgia Republican Rep. Doug Collins, a long-time critic of PBMs.

We probably won't know until after Election Day if the committee will hold the requested hearing. A lot will depend on the up and down ballot tallies on Nov. 8.

The NCPA PAC depends on your personal donations to make campaign contributions to congressional candidates who are supporters on independent community pharmacy. Now is the time to have maximum political impact. Make a donation today.

Doug Hoey

P.S. In addition to October being both American Pharmacists Month and Talk About Your Medicines Month, Oct. 15 kicks off the open enrollment period for Medicare Part D plans that runs through Dec. 7. NCPA announced yesterday in eNews that it had created a number of resources to help pharmacists assist Medicare beneficiaries seeking information. Here's the resources link in case you missed it.