We need everyone to stop PBMs in their tracks | NCPA Executive Update | February 23, 2024

NCPA February 22, 2024

Dear Colleague,

Doug Hoey If someone told you that up was down and down was up, what would you say to them? Would you laugh it off? Would you call them a joker? Would you call them something worse?

When it means the health of millions of Americans and the livelihoods of tens of thousands of independent pharmacy owners and their pharmacy teams, logical conceits aren't funny. They're downright dangerous.

When PCMA rolled out a recent campaign video to fool anyone with a video screen, no one at NCPA was laughing. It is rife with half-truths, mistruths, and bald face lies about how insurer PBMs are promoting competition and improving health—played to the dulcet tones of a tinkling piano in the background. YOU know the truth but this is the kind of messaging your member of Congress and their staff is seeing inside the Washington DC beltway. Do THEY know the real truth?

It's a horrendous example of misinformation and my message to you this week has special importance: I urge you to contact your U.S. Senators and Representatives.

NCPA has been building up to this action for months now, and now is when your involvement has never been more critical. Medicaid reform and Medicare reform are at stake. If you're like the average community pharmacy owner, those two programs represent over 50 percent of your business. You've seen what's going on in Medicare Part D and you understand the need for reform. Thanks to your help, NCPA has coordinated sending thousands of messages to Capitol Hill in the last few weeks, and we need to send thousands more to make sure every single lawmaker hears from community pharmacy owners multiple times. When they hear from us, they understand what's at stake. When they hear from you, they understand why it matters.

Our priority legislation is nearing the end zone and only your elected officials can push it across the goal line. Tell them to pass legislation that saves taxpayers money and provides patient access to their independent pharmacies:

  • S. 2973, the Modernizing and Ensuring PBM Accountability (MEPA) Act (passed 26-1 out of the Senate Finance Committee)/H.R. 5378, the Lower Costs, More Transparency Act (passed the House of Representatives on an overwhelming bipartisan vote of 320-71)

    • Bans spread pricing in Medicaid managed care by requiring a fair and transparent Medicaid reimbursement to pharmacies and saves over $1 billion!

  • S. 3430, Better Mental Health Care, Lower-Cost Drugs, and Extenders Act (unanimously passed the Senate Finance Committee)

    • Includes the No PBMs Act which requires CMS to define reasonable and relevant contract terms in Medicare.

  • S. 127, the Pharmacy Benefit Manager Transparency Act (passed 18-9 out of the Senate Commerce Committee)

The bottom line is that insurer PBMs spent $15.44 million in 2023 on their lobbying efforts to increase their profits and put patient access and safety at risk. That's a whopping 78 percent more than they spent in 2022! One third of PCMA's spend happened in the last quarter of 2023—and no doubt they are gearing up for an election-year propaganda blitz. If you are confident with your elected officials only hearing the PBM's view of the world, then sit on your hands and hope for the best.

Alternatively, Community Pharmacy doesn't have the gobs of money of the insurer-PBMs but all that money can't muzzle community pharmacy owners! Speak up!


Doug Hoey

B. Douglas Hoey, Pharmacist, MBA