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Federal Regulations Threaten Patient Access to Prescription Drugs Says NCPA

Posted on: Thursday, 8 February 2007, 15:01 CST

ALEXANDRIA, Va., Feb. 8 /PRNewswire-USNewswire/ -- Tens of thousands of patients may be denied access to life-saving prescription drugs if Medicaid regulations cutting community pharmacy reimbursement rates go into effect as planned by federal government bureaucrats. According to a recent study by the Government Accountability Office (GAO), the proposed Medicaid pharmacy reimbursement cuts will force pharmacists to accept Medicaid drug reimbursement that is, on average, 36 percent below their cost. Survey results announced today by the National Community Pharmacists Association (NCPA), reveal that 86 percent of independent community pharmacists say proposed regulations, as evaluated by the GAO, will influence their decision to continue participating in the Medicaid program.

"Proposed Centers for Medicare & Medicaid (CMS) changes to Medicaid pharmacy reimbursement will drive pharmacies out of Medicaid, and even out of business," said NCPA President John Tilley, RPh, a pharmacy owner from Downey, Calif. "The consequences threaten the health and safety of millions of Medicaid recipients -- more than half of whom are children. In thousands of communities across the nation, the local community pharmacy is a vital, indispensable community health resource. Government policies that drive independent community pharmacies out of Medicaid, or even out of business, will result in increased costs to taxpayers in terms of emergency room visits, hospitalizations, and other unintended health consequences. A pharmacy closed because of Medicaid regulations means its Medicare and all its other patients lose, too."

The cuts proposed by CMS for Medicaid reimbursement to pharmacies would have a disproportionate impact on the nation's 24,000 independent community pharmacies because 92 percent of their business comes from prescription drugs, and independents serve large populations of Medicaid recipients in urban and rural areas.

In December, CMS proposed $8.4 billion in Medicaid cuts over the next five years. More than 90 percent of those cuts are expected to come from slashing pharmacy reimbursement for lower-cost generic prescription medicines to Medicaid patients. High-priced brand name drugs are left untouched.

The NCPA survey, conducted in January, asked independent community pharmacists if proposed regulations requiring them to accept Medicaid reimbursement at 36 percent below their cost, as determined by GAO, would affect their decision to participate in the program. Of more than 800 pharmacists responding, 86 percent said it would influence their decision, 3.4 percent said it would not, and 8.4 percent were unsure. Only 1.8 percent of respondents are not currently participating in the Medicaid program. Medicaid represents about 20 percent of the prescriptions dispensed, on average, by independent community pharmacists. For more than 10 percent of pharmacists surveyed, Medicaid represents 50 percent or more of the prescriptions they dispense.

"Medicaid cuts, combined with low and slow reimbursement under the Medicare Part D program, could force many pharmacies to close so that ALL patients lose access," said NCPA Executive Vice President and CEO Bruce Roberts, RPh. "In many areas, the local independent is the only pharmacy for miles. The local community pharmacy is a crucial health care resource that's taken for granted -- until it's gone. In the aftermath of Hurricane Katrina in the Gulf Coast region, it became clear that protecting patient access to community pharmacies is an issue that rises to the level of public health policy. Now it's not a natural disaster, but a government policy disaster, that threatens this vital community health resource."

NCPA is pursuing legislative remedies in the Congress to ensure that independent community pharmacies can afford to continue serving Medicaid recipients, as well as state legislation addressing inadequate professional dispensing fees.

The National Community Pharmacists Association, founded in 1898, represents the nation's community pharmacists, including the owners of more than 24,000 pharmacies. The nation's independent pharmacies, independent pharmacy franchises, and independent chains dispense nearly half of the nation's retail prescription medicines.

National Community Pharmacists Association

CONTACT: Robert Appel, Senior Vice President, Communications, of theNational Community Pharmacists Association, +1-703-838-2682,bob.appel@ncpanet.org

Source: PRNewswire-USNewswire

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