Dear Colleague,
President Trump today signed a spending package for the Department of Health and Human Services that includes high priority reform that NCPA has been pushing for years. The provision, which is now law, directs the Centers for Medicare & Medicaid Services (CMS) to develop and enforce reasonable and relevant contract terms in the Medicare Part D pharmacy program. It also creates a mechanism for pharmacies to report PBM contract violations.
This is a major victory for independent pharmacy. Medicare represents almost one-third of the average pharmacy's business and is by far the most dominant payer for pharmacies. I would like to thank all of you for having played a big part in this. Thousands of you have written letters to Congress over the years. Thousands more have attended our annual Congressional Pharmacy Fly-In to educate your federal representatives. Hundreds of you have hosted pharmacy visits with your members of Congress. Many of you have made donations to the NCPA PAC to help elect pharmacy champions to Congress. Many of you have donated to the NCPA Legislative and Legal Defense Fund, which finances NCPA's lobbying, legal, and public education activities. Many of you have participated in various NCPA campaigns, talking to your patients and getting them involved. And you stayed in the fight even after some setbacks.
At the end of 2024, at the very last possible moment, the broader PBM reform package, which included the reasonable and relevant provision, died in a fiery car crash caused by Elon Musk via Twitter (now X), when he urged Republicans in Congress to kill a year-end spending bill in which it was included. Even earlier in 2024, PBM reform became hostage to other health care provisions that did not have the same bipartisan support and all the health care provisions were ultimately removed from that funding package.
But you didn't quit, and neither did we. In the summer of 2024, NCPA launched the Finish the Fight campaign. Anticipating this moment, we revved it back up last month. Overall, that campaign produced almost 100,000 letters — including 12,000 just in the last 6 weeks — from patients to Congress demanding PBM reform. Importantly, in recent months, thousands of you sent your own letters.
Today is the payoff for all that persistence. It is the first major federal PBM reform in history! And it's the first time since the creation of the Medicare Part D program in 2003 that PBMs will be affected.
I would like to extend a special thanks to our champions on Capitol Hill, especially Rep. Buddy Carter (R-Ga.), Sen. Marsha Blackburn (R-Tenn.), Chairman Mike Crapo (R-Idaho), and Sen. Ron Wyden (D-Ore.), Rep. Diana Harshbarger (R-Tenn.), Sen. James Lankford (R-Okla.), all of the cosponsors of the PBM Reform Act (H.R. 4317) and the PBM Price Transparency and Accountability Act (S. 3345), and congressional leadership as well as leaders of the House Committee on Energy and Commerce and Senate Committee on Finance. They've been fighting for years to get this done.
I would also like to assure you that we are not finished. We'll be gearing up at the federal level and in the states to reform state Medicaid managed care this year so independent pharmacies are paid fairly. We'll keep working with the Federal Trade Commission and the Department of Justice to make sure PBMs, insurance companies, and other big corporations play by the rules. And we will work hard this year to support candidates for Congress who support independent pharmacy.
So, enjoy this victory. You've earned it. But there's more work to do. In fact, please mark your calendar for the 2026 NCPA Congressional Pharmacy Fly-In, April 15 and 16 in Alexandria, Va. It's the most important grassroots event of the year, when hundreds of NCPA members fly in to meet with their congressional representatives and their staffs, and educate them on the need for reforms. It's a chance to say thank you for fighting, but we aren't done yet. I hope to see you here. In the meantime, congratulations.
Best,
B. Douglas Hoey, Pharmacist, MBA
NCPA CEO
