Includes “AMP,” “MTM” and “DME Accreditation” Provisions
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(HealthNewsDigest.com) – Alexandria, VA – Three pharmacy provisions advocated by the National Association of Chain Drug Stores (NACDS) are included in the healthcare reform bill advanced last night by the U.S. House of Representatives.
The bill includes provisions that were part of the healthcare reform measure passed by the Senate in December 2009, including those related to:
a series of grant and pilot programs that include medication therapy management (MTM);
improvements to the Medicare Part D MTM benefit;
reductions in the patient-care-jeopardizing cuts to Medicaid pharmacy reimbursement under the average manufacturer price (AMP) model; and
a conditional exemption for pharmacies from the durable medical equipment (DME) Medicare accreditation requirements.
The advancement of the NACDS-urged MTM provisions demonstrates results for NACDS’ vision that pharmacy will own the issue of medication adherence, which refers to helping patients take the right medications in the right ways. NACDS has emphasized pharmacy’s ability – through services including MTM – to help reduce the estimated $290 billion in annual costs that result from poor medication adherence, amounting to 13 percent of all healthcare expenditures.
Regarding the Medicaid AMP issue, the legislation includes important changes in the definition, and method of calculating AMP, as compared with the Deficit Reduction Act of 2005. These changes, long advocated by NACDS and pharmacy allies, are essential to achieving a better approximation of pharmacies’ costs for purchasing generic drugs. The bill also would ensure federal upper limits are set using a multiplier of “no less than” 175% – much higher than the levels set under the Deficit Reduction Act of 2005, which would cripple pharmacy’s ability to serve Medicaid patients. NACDS and allied organizations fought to prevent Congressional negotiations from settling on a multiplier of less than 175%, and remain committed to working through the regulatory process to maximize the multiplier to advance truly pro-patient, pro-pharmacy policy. The “no less than” language is vital to this effort.
The conditional exemption for pharmacy from the accreditation requirement for providing DME to Medicare beneficiaries would help maintain seniors’ access to needed products from their neighborhood pharmacies. Pharmacies are state licensed and reputable healthcare providers, and other such providers have been afforded this exemption.
“The important takeaway is that pharmacy’s provisions have been maintained through another step in this process,” said NACDS President and Chief Executive Officer Steven C. Anderson, IOM, CAE. “Some very supportive leaders on Capitol Hill stepped up and kept these issues in the mix, and we appreciate their pro-patient, pro-pharmacy commitment. As we have said all along, advancing NACDS’ priorities will require continued vigilance as the legislative process unfolds, and into a regulatory process – this in many ways is still the early stage of our campaign to advance pharmacy’s value and viability as the face of neighborhood healthcare. We very much appreciate and value those pharmacy champions in Congress who are standing with us.”
The AMP, MTM and DME accreditation provisions were among those advocated strongly by the NACDS RxIMPACT Day on Capitol Hill (March 10 and 11). During this event, more than 250 NACDS members, pharmacy school students and faculty, state pharmacy association representatives and other pharmacy advocates conducted more than 220 meetings with their elected officials. In addition, more than 1,500 letters were sent to Capitol Hill during the “virtual Hill day” that supplemented the in-person meetings.
The National Association of Chain Drug Stores (NACDS) represents 154 traditional drug stores, supermarkets, and mass merchants with pharmacies – from regional chains with four stores to national companies. NACDS members also include more than 900 pharmacy and front-end suppliers, and over 70 international members from 24 countries. Chains operate 37,000 pharmacies, and employ more than 2.5 million employees, including 118,000 full-time pharmacists. They fill more than 2.5 billion prescriptions annually, which is more than 72 percent of annual prescriptions in the United States. The total economic impact of all retail stores with pharmacies transcends their $815 billion in annual sales. Every $1 spent in these stores creates a ripple effect of $3.82 in other industries, for a total economic impact of $3.11 trillion, equal to 26 percent of GDP. For more information about NACDS, visit www.NACDS.org.
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