To cut the deficit, Congress should consider adopting common-sense reforms to reduce federal health care expenditures without compromising patients’ access to their pharmacy of choice or harming local jobs, according to the National Community Pharmacists Association (NCPA).
The group presented their recommendations in a letter to the leaders of the new Joint Select Committee on Deficit Reduction.
“We believe that significant savings can be found through simple reforms to programs like Medicare and Medicaid that will result in reduced drug costs for the federal government and consumers,” NCPA executive vice president and CEO B. Douglas Hoey, RPh, MBA, stated in a press release.
NCPA’s letter made the following recommendations to lawmakers:
Increase the use of lower-cost generic medications. Generic drugs are one-fifth of the cost of brand-name drugs and nearly every federal health program can increase the proportion of prescriptions filled with generics. Community pharmacists dispensed generics 72% of the time in 2010 – 10 percentage points higher than mail order facilities, which profit from brand manufacturer rebates. A five percentage point increase in generic dispensing in Medicare Part D and Medicaid would result in about $9 billion in annual savings.
Better management of patients’ drug therapy. Studies have found that services such as medication therapy management provided by community pharmacists can help reduce the price, estimated to be as much as $290 billion annually, of improper medication use.
Collect billions of dollars in manufacturer rebates currently retained by pharmacy benefit managers (PBMs). The U.S. Department of Health and Human Services Office of the Inspector General has found that, in the Medicare Part D program, PBMs do not pass on to beneficiaries the full amount of rebates and that PBMs and other Part D plan sponsors routinely underestimate future rebates. Both practices lead to higher premiums and overpayments by the government. Instead, the government should insist on full, 100% pass-through of rebates. More broadly, in Medicare Part D, Medicaid, the Federal Employees Health Benefits Program (or FEHBP), TRICARE and other programs billions of dollars in savings remain on the table due to the lack of competition in and oversight of the major PBMs’ management of drug benefits.
Ensure patient choice in pharmacy; avoid mandatory mail order requirements. Community pharmacists routinely encounter patients disposing thousands of dollars worth of unusable, excess medication received through the mail. In Medicare Part B, the same has been true for products such as diabetes test strips.
