News Releases - 2017

NCPA CEO to Congress: Pharmacists Can Help Reduce Spending, But Problems Associated With Middlemen Must Be Fixed

by NCPA | Dec 13, 2017

ALEXANDRIA, Va. (Dec. 13, 2017) — In testimony before the U.S. House of Representatives Energy & Commerce Subcommittee on Health, National Community Pharmacists Association CEO B. Douglas Hoey, Pharmacist, MBA, said pharmacists can drive better health outcomes and reduce costs, but first pharmacy benefit managers' problematic business practices must be addressed through legislative and regulatory channels. As an example of one solution, NCPA urged support for the Centers for Medicare and Medicaid Services' proposed rule addressing the PBM-generated direct and indirect remuneration (DIR) fees in Medicare Part D.

"Over the past few years, CMS has been testing new payment and care models across hundreds of community pharmacies," Hoey said in his shorter remarks to the Subcommittee. "Early findings suggest high patient satisfaction, improved outcomes, and reduced overall health care spending, with reductions of greater than $1,000 per year for those patients who received high-level clinical intervention. To achieve that future promise, however, systemic barriers must be overcome. We believe intermediary parties—pharmacy benefit manager "middlemen"—are increasing pricing complexity and contributing to higher prescription drug costs."

In his submitted testimony, Hoey said, "The overly concentrated and largely unregulated PBM industry exerts immense influence over how prescription drugs are accessed by the majority of Americans. Given the fact that the federal government is the largest single payer of health care in the United States, it makes financial sense for Congress to demand increased transparency into this aspect of the prescription drug marketplace in order to identify potential savings. In addition, Congress could enact common-sense legislation to address the proliferation of PBM-generated pharmacy 'DIR' fees to lower out-of-pocket costs to Part D beneficiaries and reduce federal government Medicare Part D spending."


The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 22,000 independent community pharmacies. Together they represent an $80 billion health care marketplace and employ more than 250,000 individuals on a full- or part-time basis. To learn more, go to, visit, or follow NCPA on Twitter @Commpharmacy.