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.

All the News That's Fit to Print | NCPA Executive Update | June 2, 2017

by NCPA | Jun 02, 2017

Dear Colleague,

Doug Hoey

It's not every day that a Pulitzer Prize winning reporter from The New York Times asks if they can follow you around during your visits on Capitol Hill, but that's exactly the request NCPA received a few weeks ago during the NCPA Congressional Fly-In. The subsequent story ran on the Times' front page (above the fold for those of us who still like the feel of paper) this past Tuesday (May 30) and prominently featured NCPA members.

The focus of the story was the skirmish over increasing drug costs between PhRMA, generic manufacturers, PBMs, and NCPA. Eric Lipton was the Times reporter who accompanied the Georgia delegation attending the NCPA Fly-In on its Hill visits. I have to admit to a momentary dash of uneasiness about showing the good, the bad, and the ugly to an obviously very observant reporter. For independent pharmacies, however, it was a pretty easy calculus because our members' agenda is transparent: Give us an even playing field, and allow us to take care of our patients and make a decent living—that's all that we ask.

The online edition of the story featured a graphic from NCPA's new "PBM Storybook" along with photos of the sizeable Georgia delegation on the Hill (thanks GPhA!). And, it also featured the bogus blast email sent to congressional offices alleging that pharmacists were on the Hill just to line their pockets. The Times reporters traced the email back to a public relations firm. After being hung up on a few times, the reporter called the PR firm's headquarters and found out—brace yourself for this shocking news—that they were a hired gun for Express Scripts. So much for transparency.

If you think about it, two of the major funding streams for PBMs come from pharmacies and consumers. So, the funds used to pay that PR firm to undermine independent pharmacies and compromise patient care were taken from those very groups. Talk about biting the hands that feed you.

NCPA continues to champion legislation that would ban retroactive DIR clawbacks from pharmacies, and the work of NCPA and our members is moving that issue forward. (Urge your senators and representative to join us.) PBMs, on the other hand, seem to be taking on water as more and more of their tactics that contribute to the higher cost of prescription drugs are being discovered.

One very recent example, is another story in the Times. This one was in yesterday's (June 1) paper and reported on Express Scripts against the drug manufacturer Kaléo, maker of Evzio, because it says it is owed $14.5 million in fees and rebates. By itself, that is at least moderately interesting. But what is really interesting is that according to the article a deeper dive into the lawsuit filing showing that as the price of Evzio went up, so did ESI's haul.

It doesn't take Woodward and Bernstein to figure out that's an inherent conflict of interest for an industry that promotes its value to payers as controlling drug costs. Yesterday's story shows a different reality. Here are a few sentences from the story:

In January 2016, Evzio carried a list price of $937.50 for two injectors, and Express Scripts billed Kaléo for about $25,000 in administrative fees for its commercial clients for that month. But three months later, in April, Evzio's price had climbed to $4,687.50, and these fees totaled nearly $130,000. That's on top of charges that included "formulary rebates," or drug discounts, and "price protection rebates," which are triggered when a drug jumps in price. Those price-protection rebates totaled $14 million—most of the money that Express Scripts is trying to recoup.

Prescription drugs are in the headlines almost daily. These recent New York Times stories illustrate that NCPA is leading the charge for community pharmacists and the patients they serve.

Doug Hoey

P.S. I'd be remiss not to point out that it's your investments in our Legislative/Legal Defense Fund (LDF) that fuel NCPA's entire advocacy operation—including building the kind of media relationships that result in a Pulitzer Prize-winning reporter seeking us out and then producing the kind of story that appeared on page one of The New York Times this week. Our message and efforts are clearly resonating with policymakers and the media. Won't you do your part and make a "fair share" LDF investment?