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 other Friday.

You've been warned: Don't mess with North Dakota | NCPA Executive Update | September 7, 2018

by NCPA | Sep 07, 2018

Dear Colleague,

Doug Hoey

"Don't mess with Texas" was originally a slogan aimed at reducing litter in Texas but has become a bumper sticker and T-shirt catchphrase for millions of proud Texans. When it comes to community pharmacy, I'm starting to think North Dakota could appropriately adapt the slogan to read, "Don't mess with North Dakota."

North Dakota, that beautiful, chilly plains state sitting in between Minnesota and Montana and, yes, to the north of South Dakota, has for many years had the most consumer-friendly laws for pharmacy patients. Since 1963, pharmacies in North Dakota must be majority owned by a licensed pharmacist. That law has been challenged multiple times and each time the state has won. Four years ago, Walmart put its deep, deep, pockets to work to attempt to overturn state law by getting the measure on the ballot. Despite millions of dollars of out-of-state money spent trying to get the law changed, 60 percent of North Dakota voters voted against changing the law, soundly defeating the proposed change. Don't mess with North Dakota.

The latest victory for North Dakota came this week when the U.S. District Court of North Dakota issued a thorough decision denying a challenge by the Pharmaceutical Care Management Association, the organization representing 16 PBM corporations, to two of North Dakota's laws regulating PBMs and their relationship with pharmacies. Defendants in the suit, the North Dakota Board of Pharmacy, the state attorney general and the state health officer, won on nearly every claim. As a result, North Dakota may enforce the laws in their entirety – except for the plan-disclosure provision, which is preempted as to Medicare Part D plans but not preempted as to non-Part D plans, including ERISA plans. Don't mess with North Dakota.

PCMA filed an appeal Wednesday, so this battle is far from over but for now, North Dakota has continued to set the bar for the other 49 states. According to an analysis of Medicaid and CHIP Payment and Access Commission (MACPAC) data, North Dakota has the fifth lowest prescription drug costs in the U.S. Furthermore, from 2010 to 2014, North Dakota's prescription drug costs were the 13th lowest in the nation and patients there had among the best access to pharmacies. Perhaps not coincidentally, North Dakotans also have one of the highest healthy life expectancies, tying for the 10th highest.

A number of years ago, Dave Barry, Pulitzer prize-winning humor columnist (and a previous keynote speaker at the NCPA Annual Meeting), joked about North Dakota changing its name to simply "Dakota." He went on to poke good-natured fun at North Dakota and its friendly citizens with low crime, low unemployment, and a frigid climate. Friendly North Dakotans invited Barry to visit North Dakota and honored him by naming an essential municipal facility after him – the Dave Barry Lift Station No. 16, a sewage treatment plant!

Don't mess with North Dakota.

Doug Hoey

P.S. At the risk of sounding like your mother, the NCPA Annual Convention hotel deadline is Sept. 12 – that's next Wednesday! NCPA's room blocks are almost all sold out, but we have a small room block at two nearby hotels. I'm betting this meeting will be one of the best you attend all year, so you definitely want to be there. Book your hotel and register before those additional rooms are snapped up.