Don’t exclude community pharmacists
Earlier this year, Medicare proposed a rule that will foster more robust competition among pharmacies, increase rural access and give seniors more convenient interactions with trained health professionals.
At issue are favorable deals between pharmacy benefit managers and big- box pharmacies. Medicare data show that these exclusive arrangements often raise Medicare costs while boosting these entities’ profits. So it is no surprise these multibillion-dollar companies are seeking to derail the rule’s implementation.
Currently, community pharmacies are routinely being denied the opportunity to participate in “preferred pharmacy” Medicare drug plan networks. Instead, local pharmacies are often contractually obligated to charge higher copays than “preferred” pharmacies. As a result, many seniors are steered toward those pharmacies chosen by their drug plan. By letting any pharmacy willing to accept a drug plan’s “preferred pharmacy” terms and conditions participate, Medicare will increase access for patients, and we believe, lower copays.
This will particularly benefit seniors in underserved rural areas that often are served only by small independent pharmacies. After studying data illustrating how the “preferred pharmacy” experiment was actually playing out, Medicare officials concluded that letting more providers participate as “preferred pharmacies” is the best way to encourage price competition and lower Part D costs.
Because many seniors prefer to talk to a pharmacist face to face, Medicare’s proposal will let more seniors choose between community pharmacies and mail-order operations without penalty. In addition, the proposal will give more patients access to cost-saving medication-therapy-management consultations with community pharmacists— something currently not offered to them.
Opposition to the overall proposed rule is coalescing around concerns about whether certain “protected class” drugs will no longer be covered and whether the number of prescription drug plans will be too limited. The National Community Pharmacists Association understands and appreciates these concerns. However, they are unrelated to and must be considered separately from the “any willing pharmacy” and medication-therapy-management provisions.
The community pharmacy provisions of the rule are estimated to have no Medicare cost impact. We encourage policymakers to support competition, improved access and Medicare savings by implementing these pro-patient, pro-pharmacist provisions.