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Support HR 4577
8/12/2014

Background: Some health plans, particularly those in the Medicare Part D program, have selected certain national chain pharmacies to be the plan's "preferred" pharmacy. Whether they like it or not, patients in these plans must change pharmacies or pay higher co-pays to stick with their current pharmacy.

Independent community pharmacies are often excluded by, health plans from such arrangements.

Bipartisan legislation has been proposed to give many seniors greater choice of pharmacy. The Ensuring Seniors Access to Local Pharmacies Act (H.R. 4577), introduced by U.S. Reps. Morgan Griffith (R-Va.) and Peter Welch (D-Vt.), would allow community pharmacies located in a medically underserved area to participate in all Medicare Part D drug plan networks, including the plan's discounted or "preferred" network.

The opportunity for community pharmacies to participate in preferred plans which is sometimes referred to as "any willing pharmacy," would greatly benefit patients.

  • More choice of pharmacy - Increased competition gives consumers more options to choose a pharmacy based on customer service.

  • Help for rural, underserved areas - In less populated areas patients may have to travel 20+ miles to reach a "preferred" pharmacy, likely passing one or more excluded community pharmacies along the way. For example, in Florence, Ore. (population: 8,466) Medicare beneficiaries live within one mile of five different pharmacies, on average, but must travel more than 40 miles to reach a preferred pharmacy in either the Humana Enhanced or Humana Preferred Rx drug plan.

  • Diverse populations would benefit - Patients with special needs, including those for whom English is a second language, rely on the personalized care of community pharmacies that are often excluded from "preferred" status. For more, read these patient and pharmacy profiles.

  • Key consumer group support - H.R. 4577 has been endorsed by leading national patient advocacy organizations, including Consumers Union; HealthHIV, Medicare Rights Center, National Grange, National Rural Health Association, and the National Senior Citizens Law Center.

  • Medication adherence - As much as $290 billion in annual health care costs occur from improper medication use, or "non-adherence." The biggest predictor of medication adherence is patients' personal connection (or lack thereof) with a pharmacist or pharmacy staff and patients of independent community pharmacies reported the highest level of personal connection (89 percent agreeing that pharmacist or staff "knows you pretty well"), according to Medication Adherence in America: A National Report Card.

  • Greater competition and cost savings - Federal Medicare officials have concluded that the any willing pharmacy policy is "the best way to encourage price competition and lower costs in the Part D program." They identified many instances in which the sweetheart arrangements between drug plans and Big Box pharmacies were actually INCREASING costs. However, Congress must act because Medicare has refrained for now from implementing the pharmacy choice policy.

  • Take action - Contact your elected officials to ask them to support H.R. 4577, The Ensuring Seniors Access to Local Pharmacies Act. Go to www.fight4rx.org to make your voice heard.

  • Share your support for #pharmacychoice. Follow NCPA on social media: Twitter Facebook Google+YouTube