Things change. People change. | NCPA Executive Update | July 21, 2023

NCPA July 20, 2023

Dear Colleague,

Doug Hoey

In college I took a nutrition class that I loved. The professor focused on the role of vitamins, minerals, antioxidants, and the food pyramid. Remember the food pyramid? Back then, low fat diets were the gospel. The recommendation that was etched in our heads was 60-70 percent of calories should come from carbohydrates, another 20-30 percent from protein, and 10 percent from fat.

A variety of low-fat foods flooded store shelves and found their way into briefcases, purses, and brown paper lunch bags everywhere. Remember Snack Wells (which were discontinued last year)? What about Atkins Bars? Wheat Thins?

Facts can change. People change. Time eventually brings things into focus.

Yesterday, the Federal Trade Commission held an open meeting and voted to issue a statement cautioning against reliance on prior advocacy statements and studies related to PBMs that no longer reflect current market realities.

NCPA cheers this vote, and we said as much in a press release, because it doesn't leave much for PBMs to hide behind any more.

Hallelujah, and justice has its day in the sun!

This is a big win for independent pharmacy. So, what's the background here, from NCPA's perspective? I've written about the FTC several times in the last few years because healthcare consumers and community pharmacies need the FTC to intervene with PBM business practices that are choking competition and limiting patient choice. Over the last 40 years, the FTC has been a turnstile for big businesses looking for approval of their vertical mergers. And, the FTC has been happy to oblige.

As if the injury to competition wasn't enough, FTC added the insult of issuing statements in support of the monopolistic PBM practices. Case in point is a 2005 FTC report of PBM owned mail order pharmacies. I'll paraphrase the FTC's findings: Nothing to see here. PBM owned pharmacies are wonderful. PBMs latched on to this report and have extrapolated it to imply that all of their business practices have been vetted and blessed by the FTC. I've been in countless meetings where PBMs have used the FTC report as their trump card. "See, the FTC says we're a-OK!"

The FTC didn't stop there. They went on to go out of their way to send letters to individual states trying to pass pro-consumer, pro-pharmacy legislation and essentially putting a stake through the heart of the legislation by saying that reining in PBMs would raise costs. Sounds a lot like the baseless comments PBMs make whenever oversight is coming their way.

Enter the current FTC under the leadership of its Chair Lina Khan—a lightning rod for big business groups like the U.S. Chamber of Commerce—who has dared to question the conventional wisdom.

So, yesterday's vote by the FTC is a big deal. We applaud the commissioners for their vote and hope that this is just the first of more action from the FTC to rein in PBM business practices.

New information produces new discoveries. Just like the FTC's vote not to rely on their old PBM conventional wisdom, I think I'll celebrate with a bacon double cheeseburger, which is somewhere on the food pyramid. I assure you.


Doug Hoey

B. Douglas Hoey, Pharmacist, MBA

PS: If you haven't already, please complete the Community Pharmacy Impact Census by July 28! Your responses help us communicate community pharmacy's story to legislators, regulators, the media, and patients. Data from the pharmacy profiles also helps NCPA bring new opportunities to community pharmacies.