CCPA Speaks Out: Pharmacy Groups Continue to Fight AMP Rule

Ms. Khani and Mr. Sewell are copresidentsof the Coalition for CommunityPharmacy Action.

As the implementation deadlineon Average ManufacturersPrice (AMP) loomscloser, the legislative activity on CapitolHill reflects the urgency of this issuefor community pharmacy. Committeechairmen in the House and Senatehave introduced legislation to adjustthe AMP system, which threatens toforce thousands of pharmacies fromthe Medicaid program. More than 130cosponsors support a bill that wouldreplace AMP altogether.

The Fair Medicaid Drug Payment Actmakes key adjustments to the AMP-basedreimbursement limits to betterensure community pharmacy costs willbe covered when dispensing genericdrugs to Medicaid patients. The bills areS 1951, introduced by Senate FinanceChairman Max Baucus (D, MT), and HR3700, introduced by Chairman FrankPallone (D, NJ) of the Health Subcommitteeon Energy and Commerce.

The Saving Our Community PharmaciesAct (HR 3140), introduced byRep Nancy Boyda (D, KS), has attracted131 bipartisan cosponsors. This wouldreplace the AMP system with RetailAcquisition Cost based on actual pharmacyinvoices. Both bills call forincreased generic use in order to driveprogram savings.

As it stands, the rule released in Mayby the Centers for Medicare & MedicaidServices (CMS) will deal a crippling blowto community pharmacy. A staggering$8.4 billion is to be hacked from communitypharmacy's generic-drug paymentsover the next 5 years—an overall reductionof 30% of pharmacy's Medicaid currentgeneric-drug reimbursement.

The possible consequences of thisdecrease in reimbursement are alarming.Pharmacies that fill a large numberof Medicaid prescriptions could beforced to shorten hours, lay off employees,and even close down completely—all of which threaten patientaccess to prescription drug care.

The Government Accountability Officehas reported that pharmacies willbe reimbursed at 36% below their costto purchase generic medicines, onaverage. The study even questions theuse of AMP as a benchmark at all.

Inadequate reimbursement ratesreduce incentives for pharmacies todispense lower-cost generic medicines,directly contradicting present efforts toimplement cost-saving measures in theMedicaid program. For every 1% decreasein generic dispensing, Medicaidloses hundreds of millions of dollars. Inother words, CMS' proposed definitionfor AMP will not simply hurt pharmaciesand the Medicaid patients that relyon them; it could cost taxpayers billionsof dollars a year.

Community pharmacy has laboredtirelessly for a legislative solution to thislooming catastrophe. Both the NationalCommunity Pharmacists Associationand the National Association of ChainDrug Stores—along with numerousother pharmacy groups—are lobbyingCongress and enlisting support fromkey lawmakers.

The Coalition for CommunityPharmacy Action (CCPA) is analliance between the NationalAssociation of Chain Drug Stores(NACDS) and the NationalCommunity PharmacistsAssociation (NCPA), whichtogether represents more than55,000 community pharmacies.CCPA leverages the support,effort, and infrastructure ofNACDS and NCPA while engagingcommunity pharmacy to participateand advocate on issuesaffecting the industry.

Congress must act to prevent thesedevastating generic-drug cuts fromgoing into effect. The fight is not over,and, more than ever, it is essential forcommunity pharmacy to get engaged.Pharmacists should contact their electedofficials in Washington and requestthat they cosponsor these bills. Patientsshould be encouraged to do the sameto protect their access to communitypharmacy. They can personally invitemembers of Congress to visit their pharmacy,and they can submit opinionpieces to their local newspapers—anythingto promote the message of increasinggeneric use and patient accessto quality affordable medication.

The time to act is now. The future ofcommunity pharmacy depends on yoursupport.