Dear Colleague,
Medicare and Medicaid make up more than 50 percent of the average pharmacy's business. These two taxpayer-funded programs are on the verge of wiping out thousands of community pharmacies. Millions of patients, especially the socially vulnerable population, are in jeopardy of being stranded not only without access to "drugs in a bag" but without the patient care they can currently access at their local community pharmacy. CMS and Congress have the power to make the necessary changes but so far have gotten an aerobic workout coming up with excuses for impotence. NCPA hasn't given up on trying to convince them and this week we had the chance to make community pharmacy's case to another authority—the White House. NCPA was asked to identify two community pharmacy owners for a special roundtable who could talk about PBM price gouging. We went with NCPA board member
Dared Price, who owns seven pharmacies in Kansas and is also a partner in a small, transparent PBM. We also asked NCPA Developing Opportunities Committee member Chichi Ilonzo Momah, a pharmacy owner for the last 12 years who just opened a second, closed-door pharmacy in the Philadelphia area.
From Dared: "We need to end take-it-or-leave-it PBM contracts and cut-throat reimbursements," said Price, who runs the transparent, pass-through PBM Oread Rx—making his participation vital to show that controlling prescription costs for payers and paying pharmacists fairly is not an oxymoron. To the contrary, when pharmacists are paid fairly, good things happen. We saw it time after time during the pandemic when pharmacists helped save America.
From Chichi: She shared patient stories familiar to independent pharmacy owners but foreign to those used to a corporate pharmacy experience like when she spent five days battling with an insurance plan who insisted that her patient use long-acting insulin instead of short-acting insulin because the LA insulin was on their formulary! She kids you not. She also told White House officials that a cost-plus model is a good idea in Medicaid and Medicare Part D. "This will save health care dollars," she said, "and keep independent pharmacies in business to serve our patients." (As you're reading this, Chichi is also at an event this morning in Pennsylvania introducing the President and First Lady, speaking about lowering prescription costs, as well as woman- and minority-owned small businesses.)
Both Dared and Chichi also spoke about why CMS should use their existing authority to enforce "reasonable and relevant" contract terms in Medicare Part D.
The entrepreneur Mark Cuban, who also thinks the cost-plus model is a good idea, was at the table with Dared and Chichi, too. He really raked PBMs over the coals that day—and for good reason. "I can go on and on and on about the big three PBMs," he said, "and they are everything that is wrong with this industry." He even elicited a few chuckles when he stated that PBMs are "sh*ting on independent pharmacies." Yep, no argument here.
But this is not about names to tout or laurels to rest on. We're still in the middle of the biggest fight of our lives as pharmacists.
While the current outlook to include PBM reform in Congress' FY2024 funding package looks precarious, we must continue to remind Congress and the entire American electorate that the time to lower prescription drug prices and treat independent pharmacies fairly is NOW. You can help in two ways. First, by calling and emailing your legislators today, and telling them inaction is unacceptable. Remember the reforms we are advocating are pro-pharmacy, pro-patient and pro-taxpayer – a win-win-win solution. Second, by attending our NCPA Congressional Pharmacy Fly-In, taking place April 17-18 in Alexandria, Va., and Washington, D.C. Learn more and register today.
Best,
B. Douglas Hoey, Pharmacist, MBA
NCPA CEO
