Let Your Voice Be Heard

You probably did not become apharmacist in order to get involvedin politics. If you havenever written to your elected representatives,however, this could be a good timeto start.

Almost all of you have suffered fromreductions in reimbursement as youhelped dual eligibles and others shift overto Medicare prescription drug plans. Nowanother threat to already-thin profit marginsis looming: changes in Medicaid fundingthat are likely to cut reimbursement,particularly for generic drugs.

The changes are a result of the recentlypassed Federal Deficit Reduction Act of2005, which alters the way the federalgovernment pays states for drugs suppliedto Medicaid recipients.

Starting next year, the Centers forMedicare & Medicaid Services will use adifferent formula for calculating what itpays for drugs, based on a new measure,Average Manufacturers Price (AMP). Notall the details of how AMP is calculatedhave yet been set in stone, and thosedetails will influence its overall impact onreimbursement. One likely effect of thechange, however, will be a sharp reductionin reimbursement for generics.

At a time when the rising cost of drugsis a factor in spiraling health care costs,the government should be doing everythingpossible to encourage the use ofgeneric drugs. Instead, it is putting in placea plan that is likely to cut incentives forpharmacists to dispense low-cost genericsinstead of pricier branded drugs.

Even bigger implications for pharmacistsare looming. Cutting billions of dollarsfrom Medicaid drug payments will putmore pressure on already-thin profit margins.It might well be the last straw forcommunity pharmacists who are alreadystruggling to stay in business. This realitystands in stark contrast to PresidentBush's recent comments about makingsure that pharmacists do not "overchargethe system."

Although changes to Medicaid areinevitable, it is not too late to act. So, whynot write to your elected representatives?Ask them to come and see for themselvesthe contrast between what is being said inWashington and the reality of running apharmacy.

Tell your representatives that it is essentialthat AMP is calculated in a way thatis fair to pharmacists so that they can continueto offer help to the millions ofMedicaid recipients. Explain that there is adanger that the government, in trying to cutMedicaid costs, will actually discourage theuse of cost-saving generic drugs. Ask themto vote against the even deeper cuts thathave been proposed for the Medicaidbudget beyond next year. If you are frustratedand angry, you can bet that thousandsof other pharmacists feel the sameway.Together, we can make a difference.

Mr. Eckel is professor and director ofthe Office of Practice Developmentand Education at the School ofPharmacy, University of NorthCarolina at Chapel Hill.