PHARMACY

NCPA lobbies for bills that would help mitigate market dominance of new super-PBM ESI

BY Michael Johnsen

WASHINGTON — The battle for public opinion and legislative sway was in full swing Monday as executives from the National Community Pharmacists Association lobbied congressional leaders regarding several pieces of "pro-patient, pro-pharmacist legislation." To counter that effort, the Pharmaceutical Care Management Association issued some marketing firepower of its own.

To support NCPA’s Legislative Conference in Washington May 7 to 9, the association of independent pharmacies took out  advertisements in support of "pro-patient, pro-pharmacist legislation."

The first ad makes the case for how NCPA-backed legislation can empower community pharmacists to help reduce costs and improve health outcomes while supporting local jobs. According to the ad copy, community pharmacy supports 340,000 jobs all told, including some 63,000 neighborhood pharmacists. And nearly 80% of NCPA members offer free, same-day delivery to patients.

A second ad, “Why PBM Reform is Needed,” describes the heightened need for reforming pharmacy benefit managers in the wake of the Express Scripts-Medco merger. "When the merger of two of three largest pharmacy benefit managers — Express Scripts and Medco — was announced, the question was would the Federal Trade Commission rubber-stamp it? We got our answer," the ad reads. "[This] despite concerns being raised by more than 80 members of Congress and outright opposition from consumer, business and pharmacy groups."

The PCMA fired back with a public message of its own, specifically targeting Walgreens and the NCPA. "Employers know what mega-chain Walgreens and its ‘independent’ drug store surrogates want," the ad reads in an attempt to reframe the battle as between the retail pharmacy industry and employers.

"This agenda is promoted by local drug stores, but it raises costs for every other business in town and mostly benefits Walgreens — a $70 billion company that doesn’t need the help," stated PCMA president and CEO Mark Merritt.

According to the advertisement, PCMA suggests the retail pharmacy industry is attempting to stop the redirection of pharmacy patients into a pharmacy benefit manager’s own mail-order pharmacy program; is attempting to force plans to include drug stores that "overcharge"; and is demanding higher payments (relative to prescription drug costs) from the government and employers.

Responding to that ad, NCPA spokesman John Norton noted that none of the legislation supported by industry would prevent employers and plan sponsors from offering mail-order pharmacy. And the NCPA’s support of H.R. 1971 would mandate that community pharmacy accept any terms applied to the entire pharmacy network.

Norton responded to the final PCMA assertion, that community pharmacy is demanding higher payments, with this: "As pharmacist Joe Lech … testified before Congress: Drug costs are up, PBM profits are up, co-payments are up, premiums are up, while pharmacy reimbursement is down — so where is the money going?"

Over the next few days, the NCPA will be lobbying support for the following legislation:

  • H.R. 1971/S.1058, the Pharmacy Competition and Consumer Choice Act, to preserve patient choice of pharmacy and bring transparency to pharmacy benefit managers;

  • H.R. 4215, the Medicare Pharmacy Transparency and Fair Auditing Act, to clarify Medicare Part D generic drug reimbursements and prevent abusive audits of pharmacies;

  • H.R. 1946, the Preserving Our Hometown Independent Pharmacies Act, to allow pharmacies to negotiate contracts with PBMs; and

  • H.R. 1936, the Medicare Access to Diabetes Supplies Act, to protect seniors’ access to needed testing supplies and face-to-face advice at local pharmacies.


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Purdue Pharma launches free educational resource to combat drug abuse

BY Alaric DeArment

STAMFORD, Conn. — Drug maker Purdue Pharma has introduced a new educational resource for healthcare professionals designed to curb the abuse of prescription drugs, the company said Monday.

Purdue announced the launch of the free "Patient Evaluation Resources for Opioid Risk Management," abbreviated "Perform." The company has been active in efforts to prevent misuse of prescription drugs as one of its lead products, the opioid painkiller OxyContin (oxycodone), is a frequent target for abuse.

"Substance abuse can impede medical care and may even be life-threatening," Albany Medical College neurology professor and Albany Medical Center Comprehensive Pain Center director Charles Argoff said. "I helped developed Perform because it is important for healthcare professionals to be able to recognize and address substance abuse in order to address medication therapy adherence and to intervene when appropriate."

Perform combines an interactive CD-ROM and resource binder and includes case vignettes to illustrate patients at various risk levels of abuse; patient-screening tools; documentation and monitoring information; and links to other resources.


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Answering the Express Scripts challenge

BY Jim Frederick

Walgreens just took another leap forward in its drive to become America’s “first choice for health and daily living” and “a centerpiece in improving patients’ overall health.”

On May 7, the pharmacy giant announced it had completed its $225 million buyout of BioScrip’s community specialty pharmacies and centralized specialty and mail-service pharmacy businesses. The deal includes a national network with 30 BioScrip locations in 16 states and the District of Columbia, heavily focused on HIV, oncology and transplant patients.

Company leaders said the addition of BioScrip’s big specialty pharmacy network fits the “Well at Walgreens” strategy and marketing theme by bringing “additional specialty pharmacy products and services closer to patients” and advancing the potential for what community pharmacy can bring to the nation’s frayed healthcare network. It also “creates a strong network of support for our core drug store business to provide specialty pharmacy solutions to our patients,” said Kermit Crawford, Walgreens president of pharmacy, health and wellness.

Those benefits come none too soon. Beginning in January, Walgreens saw a hefty chunk of its prescription business bleed away following last year’s bitter contract dispute with pharmacy benefit management giant Express Scripts. With relations between the two companies severed over the issue of prescription reimbursement levels, millions of ESI members have taken their business to Walgreens’ competitors.

The company’s recent monthly sales reports clearly reflect the loss of those customers. Walgreens saw its total sales drop 3.7% in April, compared with April 2011, despite a larger store base, with scripts filled at comparable stores down 7.8% from prior-year levels and even front-end sales decreasing 0.5% from the same period last year. With ESI members accounting for 12.6% of Walgreens’ total prescriptions dispensed in April 2011, customer traffic for the combined March/April period was down 2.3%, compared with last year. One bright spot: average customer basket size was up 1.8%.

(See the full report here.)

Walgreens’ answer to critics who opposed its line-in-the-sand refusal to knuckle under to ESI’s pharmacy reimbursement terms has been to take its lumps in short-term declines in store revenues, while charging full-speed ahead with its long-term strategy of becoming the nation’s go-to resource for a broad spectrum of health-and-wellness services. With its increasing push into specialty and mail-order pharmacy via BioScrip and other acquisitions, its growing network of pharmacies and wellness clinics at employer worksites, more than 350 in-store Take Care health clinics, and an expanding menu of pharmacy services like immunizations, medication adherence programs and health screenings, the company wants to become “more than a drug store,” Walgreens president and CEO Greg Wasson said.

“Becoming ‘My Walgreens’ in every community across America is a lofty goal,” he told shareholders. “But with our expansive network of stores, expanding healthcare services and commitment to creating a satisfying customer experience, we can own the strategic territory of ‘well’…in every community we serve.”

Are Wasson and Walgreens on the right track? Will the drug store giant’s bold vision to become the nation’s top retail health and wellness destination be enough to offset the loss of its ESI customers and the constant pressure on pharmacy margins exerted by other PBMs, not to mention Medicare and Medicaid? Let us know what you think.

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