ALEXANDRIA, Va. -- In a move to protect patient access to community pharmacies, the National Community Pharmacists Association (NCPA) praised Reps. Nancy Boyda (D-Kan.), Jo Ann Emerson (R-Mo.), and a bipartisan coalition of 30 House members for introducing H.R. 3140, the Saving Our Community Pharmacies Act of 2007.

The bill provides four modifications to the Centers for Medicare & Medicaid Services' (CMS) Medicaid generic prescription drug pharmacy reimbursement formula that will cause many community pharmacies to either limit the amount of Medicaid services they provide, get out of the program entirely, or even out of business.

CMS' new formula is based on the Average Manufacturer Price (AMP) from the 2005 Deficit Reduction Act's mandate to find $8.4 billion in Medicaid cuts, 90 percent coming from pharmacy reimbursement-although pharmacy only represents 2 percent of Medicaid spending. This ill-advised objective was achieved by including several pricing categories that push down the typical acquisition costs to dispense drugs well below what community pharmacies actually pay.
Rural and dense urban centers, which often lack many health outlets, are a common location for community pharmacies and have a substantial Medicaid customer base. The final rule was issued on July 6 and the implementation process begins on October 1 and is completed on January 30. At that point, community pharmacies will feel the full brunt of the reduced reimbursement.

Since Medicaid is designed to meet the health needs of poor and disabled Americans, with 50 percent being children, the prospects of community pharmacies struggling to be financially viable creates a slippery slope. When these vulnerable patients' access to prescription drugs is limited, their health will be endangered, and expensive visits to emergency rooms and doctors' offices will increase. In the most extreme cases of pharmacy stores closing their doors, all of their patients lose, such as those who get their medications from Medicare Part D.

H.R. 3140 seeks to rectify the pricing discrepancies and maintain the beneficial relationship between community pharmacists and patients by:

- Redefining the pharmacy reimbursement benchmark to accurately reflect pharmacy acquisition costs.
- Excluding all sales to mail order facilities, as well as any pharmacy benefit manager (PBM) rebates and price concessions that are not available to retail pharmacies.
- Properly defining the retail class of trade to only include retail community pharmacies.

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