I thought I should expand on a brief note that I have sent to the White House and posted on Facebook. Maybe, though, rather than expand it, I would be better off trying to get it down to tweet size! (Added text in italics)
I am not a lobbyist. I am a practicing pharmacist with a few suggestions for my professional arena that I think will help make America greater.
1. Immediately make all pharmaceutical manufacturer’s discount cards eligible to be used by patients with Medicare. This exclusion is just a lobbyist-fueled, mean-spirited obstacle for those patients most in need of our help with exorbitant drug costs. This is an apparent attempt to avoid violating the Medicare Anti Kickback statute. Congress enacted the Anti Kickback Statute as Amendments to the Social Security Act in 1972. It was more recently revised in 2010 as part of ACA. In pharmacy, one notable case involved Walgreens in a 2012 settlement of $7.9 million. Walgreens, of course, denied any fault. They had simply offered gift cards Medicare and Medicaid beneficiaries in exchange for transferring their prescriptions to Walgreens. I suppose this is similar in concept to a drug company offering to reduce a copay for a Medicare patient’s brand name med. The difference is that patients are given an Rx for a specific drug. It’s not like they can simply go across the street to a competitor. Too often, a patient struggles, trying to decide where the money will come from to pay for their fancy post-op blood thinner or the latest and greatest diabetes med that may lower their A1C by half a point. It’s OK if you are privately insured though! This distinction helps to contribute to the high cost of brand name medications and should be modified as soon as possible. Easily remedied with an executive order! Notice these cards not only exempt Medicare patients but also our veterans covered by TriCare or other DOD plans!
2. Create a third category of pharmaceuticals that could be ordered by pharmacists for the benefit of their patients. Drugs to be included in this category can be selected by a small pro-tem committee of a practicing pharmacist, an academic pharmacist, a physician, a representative of PHRMA, and a consumer. This idea has been in various stages of discussion for as long as I can remember. There seems to be a concerted among powerful lobbying groups to prevent it from ever happening. As always, the reason is money. I’m sure the AMA sees it as an attack on their rice bowl as does the insurance industry. As a colleague of mine pointed out (thanks, Andrea!) Big Pharma should be with us on this after seeing what pharmacy has done to increase sales of immunizations. Easily remedied with an executive order!
3. Immediately grant pharmacists provider status. Congress has dithered with this long enough. Make it so. The latest iteration is a proposed statute granting provider status in rural, under-served areas ONLY. That’s a bunch of crap. The value of pharmacists in the delivery of health care and the resulting improvement in outcomes and cost and been well documented many times. Easily remedied with an executive order!
I tried to keep this message brief and would be happy to discuss or answer any questions that you may have.
Let’s make pharmacy greater!