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.

When It Comes to Speaking for Patients, NCPA Has a Great Partner in State Associations | NCPA Executive Update | March 10, 2017

by NCPA | Mar 09, 2017

Dear Colleague,

Doug Hoey

This legislative season, NCPA is joining with partner pharmacy groups to advocate for measures that protect community pharmacy patients. Across the country, state pharmacy associations are speaking up for patients by advocating for an end to PBM abuses that directly affect them. They are working to prohibit, via legislation, a range of opaque practices that drive up patient out-of-pocket costs or inhibit patient access to medications and pharmacists' care. NCPA supports those efforts, and our state partners are doing a great job.

Take Georgia, for instance. The Georgia Pharmacy Association is backing the "Pharmacy Patient Protection Act," legislation that outlaws mandatory mail order requirements by PBMs, forbids copay clawbacks, and prohibits anyone from interfering with a pharmacist's ability to counsel patients about less expensive alternative medications. North Dakota pharmacists are tackling some of those same issues as well.

Community pharmacists are tired of seeing their patients misled and mistreated. You see PBMs pushing patients to use PBM-owned mail order pharmacies out-of-state, even though we all know that's not always in the patient's best interest. You see PBMs charging patients a copay higher than the dispensing cost of the drug. And you see colleagues often reluctant to say anything to the patient about it for fear of violating the PBM contract and risking retaliation.

Sound familiar?

Likewise, the Pharmacists Society of the State of New York is pursuing a patient-centered legislative package under the banner "A Pharmacy Patient's Right to Care." Among other things, the package would:

  • Expand patient access to pharmacist-administered lab tests.

  • Expand patient access to immunizations administered by a pharmacist.

  • Facilitate synchronization of medication refills.

PSSNY is also supporting Gov. Andrew Cuomo's proposals to protect patients from the high costs of prescription medications, which include licensing and regulating PBMs.

Other states are taking a patient-centered approach as well. A sampling:

  • In Tennessee, legislation to end DIR fees that push seniors more quickly into the Medicare "donut hole."

  • Med sync legislation in Illinois, Indiana, Massachusetts, Maryland, New Hampshire, Oklahoma, Pennsylvania and Tennessee.

  • In Texas and Missouri, bills to expand pharmacists' prescriptive authority—bringing care and convenience to patients.

  • Immunization expansion to address public health issues in Pennsylvania.

  • In Ohio, legislation allowing pharmacists to substitute a brand epinephrine auto-injector for a less expensive alternative.

And so on.

The common theme among these types of legislation is that what's good for the patient is what matters most. And usually, what's good for the patient is good for community pharmacy.

Many of these pro-patient bills are designed to prohibit specific PBM practices. Legislators hear from us about PBM abuses, and their moral compass says, "This is wrong. This is not fair." That may explain the 35 cosponsors who signed on to the Senate version of the Georgia legislation mentioned above, and why it passed the Senate there unanimously last week.

Policymakers and media finally are finding out that PBMs contribute to the rising costs of prescription drugs and that pharmacists help to lower overall health care costs. The work our state partners are doing in their legislatures to shine a light on how PBMs mislead patients is indispensable to NCPA's overall advocacy efforts. Their success in the states bodes well for our success on our DIR and MAC bills at the federal level.

Meanwhile, pharmacists in several other states are just getting started. Their legislatures convene soon, and state associations are crafting legislation designed to protect those their members serve.

Because that's what pharmacists do: we take care of our patients.

Doug Hoey

P.S. - Legislative advocacy is what NCPA and state associations do best, but we can't protect your practice without YOU. With the intense scrutiny on PBM abuses lately, it is more important than ever for you to seize this moment and make your voice heard on Capitol Hill. Join our NCPA Congressional Pharmacy Fly-In April 26-27 as we rally in Washington, D.C., for community pharmacy and the patients we serve. All it takes is one day and your voice.

P.P.S. One more thing: Would you mind helping us quantify community pharmacies' economic impact as an employer purchaser of health care? Just complete this 60-second survey.