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6/24/2002

Coalition Urges Hastert to Consider Pharmacists During House Debate on Medicare Prescription Benefit

Cheryl A. Thompson

The Pharmacy Benefits All Coalition, composed of ASHP and eight other national pharmacy organizations, last week sent House Speaker J. Dennis Hastert, R-Ill., a letter urging him to consider the ramifications for pharmacy and pharmacists if the Medicare Modernization and Prescription Drug Act of 2002 becomes law. Debate on the legislation heads to the full House of Representatives on Wednesday.

 


June 17, 2002


The Honorable Dennis Hastert
Speaker
United States House of Representatives
Washington, D.C. 20515

Subject: Pharmacy Opposition to the Medicare Modernization and Prescription Drug Act of 2002

Dear Mr. Speaker:

Specifics of legislation to provide seniors with prescription drug coverage have just been made available to us for the first time today. The legislation is accompanied by representations that the concerns of the profession of pharmacy and the nation's pharmacists have been considered and addressed.

While our concerns may have been considered, they are certainly not reflected here, and have not been responded to in this bill. Therefore, it is important for you to know that the legislation as it is drafted will be strongly opposed by national and state pharmacy organizations, as well as practicing pharmacists who provide direct care to patients everyday throughout the country. Our groups represent the overwhelming majority of pharmacists and pharmacies from each and every practice setting throughout the United States – independents, small and large chains, hospitals, consulting and nursing home, food/pharmacy combinations, mass merchandise pharmacies, academics and faculty, and students.

What America's seniors need is a pharmacy benefit they can count on now. They need the peace of mind that comes from knowing their medication costs will not induce poverty. They need the comfort of knowing that their Medicare prescription drug plan allows them to go to the pharmacy of their choice for the medication prescribed by their doctor. Above all, they need a plan that advances patient care, not one that sets it back.

All of the organizations listed below oppose this bill because it:

  • offers no pharmacy coverage until after the 2004 elections, which is too long for seniors to wait;
  • places control of the Medicare related prescription drug program in the hands of unregulated and unlicensed pharmacy benefit managers (PBMs);
  • restricts seniors to select pharmacy providers or forces them to pay higher costs to use the pharmacy provider of their choice, possibly a pharmacy provider that they have been using for many years;
  • pushes seniors into mail order, inhibiting patient-pharmacist relationships. Evidence suggests that mail order may result in higher prescription costs and lower generic use;
  • provides no meaningful program or adequate reimbursement mechanism to assure Medicare beneficiaries have access to medication therapy management services, needed to assure appropriate medication use;
  • pre-empts virtually all state consumer protection and pharmacy benefit laws that are designed to protect patients, not PBMs;
  • includes legislative authority for CMS to establish a Medicare-endorsed prescription discount card that would allow PBMs to force pharmacy providers to discount their prices to all seniors without requiring any defined contribution from the drug manufacturer to actually lower the prescription price.

Taken together, the provisions of this legislation would impose economic hardships on pharmacy providers and could harm many neighborhood pharmacists and pharmacies who are on the front line of health care for millions of our citizens. Please keep in mind that PBMs dictate terms of reimbursement to pharmacies both under coverage and discount card programs. The notion that pharmacies are able to "negotiate" with PBMs is a fallacy. This important fact is often overlooked.

We fully support legislation to provide comprehensive pharmacy coverage for seniors. However, this proposal provides a benefit at the expense of the millions of people who receive valuable care and counseling from their neighborhood pharmacy and pharmacist.

For this reason, the organizations listed below will stand together in opposition to the "Medicare Modernization and Prescription Drug Act of 2002." We consider a vote for this bill to be a vote against pharmacy and pharmacists. We hope that through careful study and debate the ramifications of this legislation will be fully understood and considered before any votes are cast.

Sincerely,

American Pharmaceutical Association (APhA)
American Society of Consultant Pharmacists (ASCP)
American Society of Health-System Pharmacists (ASHP)
Food Marketing Institute (FMI)
National Association of Chain Drug Stores (NACDS)
National Community Pharmacists Association (NCPA)
National Council of State Pharmaceutical Association Executives (NCSPAE)
National Grocers Association (NGA)
National Retail Federation (NRF)