Gather 'round, everyone. It's Story Time! | NCPA Executive Update | April 15, 2022

NCPA April 14, 2022

Dear Colleague,

Doug HoeyIf you have children — or grandchildren, nieces, or nephews — you've heard the familiar refrain: "Tell me a story!"

Today, I'm asking you to tell a story, not to me, but to the FTC. And you need to tell this story like your business depends upon it, because it really does.

By now you probably know the rollercoaster ride we've been on with PBMs, vertical mergers, and the FTC. For years, NCPA has spoken out against health care mergers that are essentially wiping out competition in the PBM market. As regulators have approved merger after merger, the cost of prescription drugs has skyrocketed. Who pays the price? Patients, employers, and small business pharmacies suffer while these consolidated conglomerates grow and get richer. Our pleas to the DOJ seemed to fall on deaf ears, but over time we picked up support from some influential community pharmacy supporters on Capitol Hill including Sens. Ron Wyden (D-Ore.), Charles Grassley (R-Iowa) and Maria Cantwell (D-Wash.).

When Lina Khan became chair of the Federal Trade Commission last summer, we had hope for meaningful change. She let it be known that the FTC planned to intensify antitrust scrutiny of vertical mergers, and NCPA urged the agency to specifically address the anticompetitive contracting practices of already-existing vertical entities that include PBMs. But despite more than 3,000 letters from NCPA members, in February the commission split 2-2 on a proposal to launch a formal study into PBM practices. The dissenting votes by the two Republican members of the commission halted the study, but not permanently. In fact, Khan pledged to call for another vote on the issue, and after talking with FTC staff, we have optimistic that the next attempt will succeed.

Our members did a great job of telling the FTC about the harm independent pharmacies suffer as a result of take-it-or-leave-it contracts and other egregious PBM business practices. Now, they need to see how patients and consumers are affected. We know this well; every pharmacist has a front-row seat to it every day. Now we need for you to make sure the FTC gets the message loud and clear.

NCPA is providing additional comments to the FTC, and NCPA President Michele Belcher was invited to speak about the impact mergers have had on the health care industry at a meeting attended by Khan and Assistant Attorney General Jonathan Kanter on Thursday. You can read her remarks here.

Perhaps most importantly, we need help from NCPA members. Please join this fight to save independent pharmacy by sharing your personal stories with the FTC. Your comments need to be consumer-focused. How are your patients affected by mergers, big insurance, and PBM gamesmanship? Illinois pharmacy owner Nathan Vorac illustrated this well on Rx Stories, a website we created for you to tell these stories. He told of a call he received from a mail-order pharmacy instructing him to transfer to them all medications of one of his longtime patients. He said he wanted to check with the patient. He wrote:

"She tells me she never gave anyone permission to move her prescriptions. I call back and they tell me they have an automated system that calls patients, if patient hits a certain number on the phone, it gives them permission to transfer all medications. My 83-year-old patient, who we have med synced and we deliver to, had no idea about any robocalls and was so upset they called me for her prescriptions it took 15 minutes to assure her I would still be filling her prescriptions."

Most of you have stories like this, and the FTC needs to hear about them. You might think, "My story is just like this one, so I don't need to submit one." NO! That's why you do need to speak up. One story, two stories, 10 or 20 — that's a drop in the bucket. But what if the FTC sees variations on this story 10,000 times? That'll get their attention!

Tell your story through Rx Stories — and use our template to contact the FTC directly. Here's a link telling you exactly how to do it effectively.

The deadline for FTC comments is now May 25. Tell your stories. Be the change you want to see.


Doug Hoey

B. Douglas Hoey, Pharmacist, MBA