Dear Colleague,
Depending on when this edition of Executive Update lands in front of you, my NCPA colleagues and I will be on our way to or from an important meeting with the Chairman of the Federal Trade Commission, Andrew Ferguson, at Remington Drug in Remington, Virginia.
This is not an everyday occurrence. NCPA members Kevin DeMass and his son, Trevor, hosted FTC Commissioner Melissa Holyoak in Salt Lake City last October, in 2023, Commissioner Bedoya co-hosted a bipartisan roundtable with Attorney General Skrmetti in Tennessee, and FTC Chair, Lina Khan, did a fireside chat with me at NCPA's Annual Meeting in 2022, but this is the first time in my memory an FTC Chair visited a local pharmacy.
I don't need to state how important the FTC should be to the oversight of PBMs and correcting their anti-competitive business practices. Chair Ferguson has been an FTC Commissioner since March, 2024, and was named Chair in January. He voted "yes" in the release of both of the FTC's scathing interim PBM reports, and this visit originated from a meeting we had with him last summer.
The purpose of the visit is to show Chair Ferguson up-close how community pharmacies are competing against a deck that is stacked against them by PBMs wishing to rub out their competition through low reimbursements and overzealous audits. Remington Drug is an "old fashioned" pharmacy, serving the area since 1913. It even still has its soda fountain. But under the ownership of Al Roberts and Travis Hale, Remington Drug is hardly living in the past. In addition to immunizations, diabetes education, and medication synchronization, progressive services like pharmacogenomics and drug nutrient depletion are offered. Can you imagine what other amazing services they could offer if the competitive landscape was actually a level playing field!
The NCPA team has been hustling extra hard this week. On Monday, Anne Cassity, NCPA SVP Government Affairs, and I met with Senate Majority Leader John Thune (R-SD) to talk about the importance of passing PBM Reform. Pharmacies need the predictability, stability, and transparency of a "Cost Plus" model in Medicaid and reasonable and relevant Medicare contracts, a first step in Medicare reform. Leader Thune gets it, and he seemed to agree that this was one of the few bi-partisan issues in a Congress as volatile as a covered wagon full of liquid nitroglycerin.
A couple of weeks ago, Anne and I also met with Speaker of the House, Mike Johnson (R-LA). The Speaker definitely knew about the issues with PBMs and the harm they are causing pharmacies and patients. He even uses a community pharmacy for a prescription that he can't get at a big box store.
The photo-ops are nice, but the burning question is: Since these top leaders in Congress know and understand the importance of passing PBM reform (don't forget, PBM Reform is scored to save $5 billion! A handy fact when Congress is considering where they can save money). Then they should find a way to pass it! Both Leader Thune and Speaker Johnson talked about the various legislative vehicles that they have to move (like funding the government) or are very likely to move (some of the administration's top priorities like extending tax cuts). In both conversations it seemed more of a question of "How" rather than "If" PBM Reform legislation is passed. Of course, the political situation on Capitol Hill is highly volatile, so we can't make predictions. The best thing we can do is keep up the pressure. Many of you have sent letters to Congress in recent weeks. Don't be discouraged if nothing happens immediately. This is a long fight. We know for sure that nothing will ever happen if we don't keep fighting.
NCPA and our members have worked hard to build relationships with friends in high places. While we appreciate them listening, it's time for them to find a way to navigate the political process and pass PBM reform.
Sincerely,
B. Douglas Hoey, Pharmacist, MBA
NCPA CEO
