Legislative Update March 2007
March 7: Immunization bill successfully voted out of Senate Health committee
Kelly Vyzral, Director of Government Affairs
2007 promises to be a very busy year for the OPA legislative team, and that translates into a very busy year for pharmacists. We may call on you to testify before a committee, or write letters and make phone calls to your legislators. We may ask you to open up your pharmacy to a visit from your legislator. We encourage you to call and introduce yourself to your State Senator and State Representative if you haven't already done so. We want you to be a resource and a trusted voice that they can turn to when health care issues come before them.
Pharmacist Immunization. This bill is our top priority. Great News! SB 58, the pharmacists' immunization bill was favorably voted out of the Senate Health committee on March 7. We are hoping to see it on the Senate floor for a vote very soon. The companion bill HB 73, sponsored by Rep. John Adams is awaiting a hearing in the House Health committee. Please contact House Health committee members and let them know that this bill is important to you as a pharmacist. Contact $$Link
Contact Info for OH House Health Committee Members 2007
Direct link to OH House Health Committee Webpage
Freedom of Access. Another important piece of legislation is the Pharmacy Freedom of Access bill. Rep. Tom Patton (R-Strongsville) has agreed to sponsor this legislation which would prohibit mandatory mail order. It would allow an out-of-network pharmacy to fill a patient's prescription, as long as the pharmacy is willing to meet the terms and conditions set in the contract. It would also require equal co-pays, equal days-supply, and open access to any pharmacy. OPA will continue to work with the sponsor to make sure that this legislation contains all the provisions needed to meet the needs of pharmacists in Ohio.
Donated Drugs to Colleges. Rep. Shawn Webster (R-Hamilton) will sponsor this legislation which will allow manufacturers, wholesalers or pharmacies to donate unused and expired drugs to the colleges of pharmacy for instructional use. This is a great way to decrease costs for both the state and the colleges.
PBM Legislation. Thanks to a concerned and involved pharmacist, OPA was approached by two legislators who are interested in introducing PBM legislation. OPA is in the process of meeting with these legislators and crafting legislation that will include transparency, fairness in contracting, licensing with the Department of Insurance, and bonding requirements. This promises to be a very interesting campaign and one that we would like all our members to be involved in.
Pharmacy Technician Legislation. Sen. Tim Grendell (R-Chesterland) has met with OPA and other pharmacy representatives concerning the regulation of pharmacy technicians. He is interested in seeing registration and training of pharmacy technicians. We are working closely with Sen. Grendell to make sure this legislation doesn't negatively impact pharmacies.
GAO Report. Community pharmacies may be paid, on average, 36% below their acquisition cost for every Medicaid generic drug prescription filled under a reimbursement formula proposed by the Centers for Medicare & Medicaid Services (CMS), according to a report by the Government Accountability Office (GAO). On July 1, CMS plans to begin reimbursing for generics based on Average Manufacturers Price (AMP). Community pharmacies may lose money on virtually every one of those transactions, the report by GAO confirmed last week. The GAO report, together with the cost to dispense study (below), highlights the extreme shortfall between pharmacy costs and the new pharmacy reimbursement in the Medicaid program. Read the $$Link
GAO Report Summary
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Cost of Dispensing Survey. According to a national study conducted and released by the Coalition for Community Pharmacy Action (CCPA), the average cost to dispense a prescription in the United States is $10.50, not including the cost of the medication itself.
The Cost of Dispensing Study is the first of its kind, encompassing all factors related to the cost of dispensing medication, in more than 14 years. The study reflects data from over 23,000 community pharmacies nationwide. Key study findings include:
- Costs of dispensing vary significantly from state to state, ranging from an average of $8.50 per prescription in Rhode Island to $13.08 in California. Pharmacies in Mountain and Pacific regions have the highest average costs of dispensing.
- Many pharmacies serving Medicaid beneficiaries have higher than average costs of dispensing.
- Rural pharmacies fill 55% more Medicaid prescriptions per store than urban pharmacies.
- Total prescription volume is a key variable related to a pharmacy's cost of dispensing.
This will be very helpful to us as we push for changes in the reimbursement formula for Medicaid, and an increase in the dispensing fee. We will be asking for $10 for brand name and $15 for generics.
HR 4: Medicare Prescription Drug Price Negotiation Act. As part of their first "100 hours" legislative agenda, House Democrats introduced and passed the Medicare Prescription Drug Price Negotiation Act of 2007 (HR 4), that would give the U.S. Department of Health and Human Services (HHS) Secretary authority to negotiate drug prices directly with drug manufacturers. As currently designed, prescription drug prices for the Medicare Part D drug benefit are negotiated by the individual prescription drug plans (PDPs) with prescription drug manufacturers.The legislation will apparently have a tough time in the Senate, and President Bush has already said he'll veto it.
OPA will be keeping you informed of updates in all of these legislative areas. If you have any questions or comments about the issues mentioned in this article, please contact Kelly Vyzral, Director of Government Affairs, at 614.586.1497 or firstname.lastname@example.org.