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Hoey: Pharmacy Competition Good for Communities

When 80 Members of Congress voiced their bipartisan concern regarding the controversial megamerger of pharmacy benefit managers Express Scripts and Medco, many took note.

The Federal Trade Commission rubber-stamped the deal anyway, despite the concerns of lawmakers and leading consumer groups. The FTC’s unwillingness to protect patients and pharmacy competition highlights that now, more than ever, it’s critical for Congress to act swiftly to ensure patient choice and pharmacy access.

Independent community pharmacists help millions of Americans achieve better health and lower cost outcomes by promoting the proper use of prescription medication. These pharmacies also routinely provide same-day home delivery. But this week, about 200 neighborhood pharmacists are instead on Capitol Hill to deliver a message to Congress: Help save your hometown’s pharmacies and jobs.

Independent community pharmacists dispense about 40 percent of all retail prescriptions. Often located in rural or inner-city areas, these small businesses employ 315,000 people and contribute greatly to local economies, charities and tax bases. Patients voice their trust in pharmacists every year in Gallup’s Honesty and Ethics poll and give their highest customer satisfaction marks to independent pharmacies, according to surveys by Consumer Reports and J.D. Power and Associates.

Members of Congress can help preserve patients’ access to these pharmacies by supporting common-sense, bipartisan initiatives.

First, join the Congressional pharmacy caucuses. In the Senate and the House, these caucuses educate lawmakers and staff regarding issues affecting patients’ access to prescription drugs and pharmacy services.

Second, support bipartisan legislation to promote patient choice and pharmacy competition, including:

• S. 1058/H.R. 1971, the Pharmacy Competition and Consumer Choice Act, which would empower patients and give health plan sponsors basic insights into secretive, billion-dollar middlemen known as pharmacy benefit managers. These reforms are particularly important for government-sponsored prescription programs, such as Medicare Part D, TRICARE and the Federal Employee Health Benefit, where taxpayers are on the hook for any overcharges by the PBM.

• H.R. 4215, which would give community pharmacies information about how they will be reimbursed for generic drugs under Medicare Part D. It would also provide for reasonable oversight of community pharmacies to prevent fraud while safeguarding against abusive audit practices focused on growing PBM profits. Kentucky, Maryland and Utah recently enacted similar legislation on a bipartisan basis.

• H.R. 1946, the Preserving Our Hometown Independent Pharmacies Act, which would allow as many as 10 independent pharmacies to group together, if certain conditions are met, and negotiate contracts with the PBMs with more bargaining power. Fairer contract negotiations would benefit patients by providing additional competition in the market and more choices for consumers. When a major pharmacy chain with the negotiating clout of 7,000 pharmacies (Walgreens) cannot negotiate an equitable contract with a top PBM (Express Scripts), it’s obvious that the situation is even more lopsided against an independent, family pharmacy.

Third, back efforts to preserve TRICARE military families’ access to community pharmacies. TRICARE patients prefer to use their community pharmacies rather than mail order, yet the Department of Defense continues to look for ways to shift TRICARE patients to mail, in spite of well-documented mail order waste. TRICARE’s prescription drug costs can be reduced through the increased use of generic drugs, while allowing beneficiaries to use the pharmacy of their choice.

Fourth, to ensure that seniors can continue to obtain their diabetes testing supplies from independent community pharmacies, lawmakers should embrace H.R. 1936, the Medicare Access to Diabetes Supplies Act, which would help patients properly use and read their test strips and meters and preserve their access to local pharmacies, where they can obtain face-to-face consultation.

Supporting these and other pro-patient, pro-pharmacist policies will lead to better health, lower costs and stronger communities.

B. Douglas Hoey is CEO of the National Community Pharmacists Association.

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