NCPA calls for payment updates, transparency from Congress

ALEXANDRIA, Va. — As the Senate convenes its Special Committee on Aging and looks into recent rises in the price of generics, the National Community Pharmacists Association is calling for lawmakers to enact legislation that would provide reimbursement to pharmacists that reflect market costs and increase transparency. 

 

“Generic price spikes are negatively impacting patients, pharmacists and health care payers alike,” NCPA CEO B. Douglas Hoey said. "Importantly, the associated slow and low price adjustment on generic medications is wreaking havoc on the ability of small business pharmacies to remain viable and continue to provide critical medications and related care to patients. We commend Congress for conducting this hearing and urge lawmakers to take additional steps for increased transparency and adequate pharmacy reimbursement."

 

The NCPA pointed out that its recent survey of pharmacists found that from their perspective, the generic price spikes have gotten worst since they last conducted a survey in 2013. The survey also revealed the impact that price spikes are having on patients, with rising costs keeping patients from filling their prescriptions or taking less than the prescribed dose to make it last longer. The organization also took aim at pharmacy benefit management companies for not updated their payment benchmarks in a timely manner. 

 

In this era of instant communication, it is indefensible for pharmacy benefit management (PBM) corporations to wait weeks or even months before updating their pharmacy payment benchmarks in the wake of these price spikes—without reimbursing pharmacies retroactively,” NCPA said. “Pharmacists' appeals to PBMs are consistently denied or ignored and this situation is untenable.”

 

Citing the Centers for Medicare and Medicaid Services’ actions to consider maximum allowable cost drug pricing standards and require PBMs to update their prices more consistently in 2016, NCPA called for passage of H.R. 244, a bill that would require the same updates for the Federal Employees Health Benefit Program and TRICARE.