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.

Pharmacy fertilizer for strong grassroots | NCPA Executive Update | March 29, 2019

by NCPA | Mar 29, 2019

Dear Colleague,

Doug Hoey

Ever the optimist, last weekend I planted seed on my lawn to fill in bare patches. I went to the hardware store (the local one, of course!) for the best grass seed, raked the ground, poured over several bags of dirt, threw some straw over it, and prayed for rain. Those barren patches were due to a lack of strong grass roots. Community pharmacy has its own version of grassroots and encouraging them to grow deep and wide is part of NCPA's mission.

For example, by January, nearly 3,500 pharmacies responded to NCPA's call to comment on CMS' proposed rule that would prohibit retroactive pharmacy clawbacks (pharmacy DIR fees, as pharmacies have known them). That's nearly a third of all community pharmacy owners taking the time to weigh in on the proposed regulation. That's a powerful showing, and I'm confident that it made an impression on CMS officials.

On April 9, the Senate Finance Committee continues its drug pricing hearings and has asked five PBMs to appear before the committee: CVS Health's Caremark, Cigna, Humana, Prime Therapeutics, and UnitedHealth's Optum. Previously, the committee held a hearing, grilling pharmaceutical manufacturer executives about prescription drug pricing. Now, it's the PBMs' turn.

Changing the pharmacy payment model is an absolute necessity for the best interests of patients and taxpayers. The current system is complex, cumbersome, and most of all, covert. Patients and taxpayers currently have no idea what a prescription will cost, and community pharmacies don't know what they will be paid. The PBM is the only entity with a view of the entire landscape and too often, consumers, taxpayers, and community pharmacies are getting soaked.

The day after the hearing is NCPA's 51st Congressional Pharmacy Fly-In, where pharmacists from around the country will share their points of view with their representatives. Hopefully, you have already registered and made your plans to attend. If for some reason you aren't able to come to D.C. this year, you can still make your voice heard.

If your senator is on the Finance Committee, contact him or her, and thank them for having the April 9 hearing about PBMs because sunlight into this industry is desperately needed. Encourage them to ask questions about the fees PBMs charge that contribute to higher prescription drug costs. Ask them to talk about how they view their pharmacy network – as business partners in caring for patients, or adversaries that they can drive out of business through anti-competitive practices and low reimbursement?

Here's the list of senators on the Finance Committee. See if a senator from your state is on the committee:


Chuck Grassley, Iowa, Chairman
Mike Crapo, Idaho
Pat Roberts, Kan.
Mike Enzi, Wyo.
John Cornyn, Texas
John Thune, S.D.
Richard Burr, N.C.
Johnny Iskason, Ga.
Rob Portman, Ohio
Pat Toomey, Pa.
Tim Scott, S.C.
Bill Cassidy, La.
James Lankford, Okla.
Steve Daines, Mont.
Todd Young, Ind.


Ron Wyden, Ore., Ranking Member
Debbie Stabenow, Mich.
Maria Cantwell, Wash.
Bob Menendez, N.J.
Tom Carper, Del.
Ben Cardin, Md.
Sherrod Brown, Ohio
Michael Bennet, Colo.
Bob Casey, Pa.
Mark Warner, Va.
Sheldon Whitehouse, R.I.
Maggie Hassan, N.H.
Catherine Cortez Masto, Nev.

The package of grass seed I bought says I should see results in seven to 10 days. Pharmacist grassroots have a longer incubation period and, for best results, require frequent watering and weeding. The Senate Finance hearing on April 9 is a time for you to do your part to strengthen community pharmacy's curb appeal.


Doug Hoey