At its annual lobbying convention this week, the National Community Pharmacists Association plans to push on Congress to advance a year-old bill supported by U.S. Rep. Ted Deutch (D-FL) that would, among other things, force Medicare Part D benefit managers to add “willing” pharmacies to their preferred networks.
Opponents, however, argue that the bill would undermine the exclusive contracts that help keep drug prices at their lowest.
House Resolution 793, dubbed the Ensuring Seniors Access to Local Pharmacies Act of 2015, was introduced by U.S. Rep. Morgan Griffith (R-VA) in February 2015. The bill has sat with the House subcommittee on health since shortly being introduced.
“Medicare Part D drug plans were purposely set up to be private and are administered by private firms that drive hard bargains with drugmakers as well as pharmacies to get the price as low as possible,” Devon Herrick, senior fellow with the National Center for Policy Analysis, told Florida Business Daily. “Part of the reason for a narrower, or preferred, network is to drive business to those firms who are willing to cut you a better deal.”
Citizens Against Government Waste also opposes the measure, telling the House of Representatives in a recent letter that H.R. 793 is attempting to fix something that is not broken.
Supporters of the bill, however, argue that access to a participating Part D pharmacy is a big issue, particularly for seniors with limited access to transportation.
“In some cases, beneficiaries … they just don’t have a local pharmacy that’s included in their preferred network, so they’re not able to advantage of the reduced co-pays,” Deutch told Florida Business Daily. “Access is especially problematic for seniors when they have mobility and transportation issues.”
With 20 percent of its population enrolled in Medicare programs, according to an analysis from the Kaiser Family Foundation, Florida’s proportion of drug coverage recipients is among the highest in the country.
Proponents also point to a 2014 report from the government’s Centers for Medicare and Medicaid Studies that found 54 percent of Part D “preferred” networks failed to meet government thresholds for accessibility.
“When you look at South Florida, it’s easy to assume that this is not a medically underserved area,” Deutch said. “But according to the guidelines the federal government uses, there are multiple areas throughout South Florida that are underserved.”
Herricks said this effort is only the last attempt from pharmacies to affect legislation that would allow them to charge more. In Oklahoma, he said, recent legislation allows pharmacies to now contest Maximum Allowable Costs they think are too low.
“Medicare Part D is a federal program, but I’ve seen several similar type of cat grabs at the state level in state after state,” he said.
Deutch said he’s open to coming to a solution that works best for seniors.
“Certainly I’m willing to engage in discussion with anyone whose goal is to achieve greater access,” he said. “If the language needs to be tweaked to do it, that would be something we’d discuss.”