Pharmacists: H.R. 4199 Needs Your Help!

By: Mike James, P.D. Association of Community Pharmacists Congressional Network

Prescription drugs account for nearly 15% of America’s healthcare costs. Yet while Congress has spent the last year debating health care reforms, discussion on reforming pharmacy has been nonexistent. To address these rising costs and Pharmacy Benefit Manager’s (PBM) negative influence on the system, the Association of Community Pharmacists (ACP) worked with Congressman G.K. Butterfield (D-NC) to introduce the Patient Health and Real Medication Access Cost Savings Act of 2009 H.R. 4199 (the PHARMACY Bill).

There are four main points to H.R. 4199:

• Equal access for the patient to go to the pharmacy of his choice
• Establishes at the Federal level Pharmacists being recognized as Health Care Providers
• Carries manufacturers’ rebates  directly back to the Federal Program , not to the PBMs
• Establishes a pharmacy reimbursement structure

Specifically, the bill seeks to reduce consumers’ dependence on PBMs for medications by encouraging the use of lost-cost generics, guaranteeing that PBMs can not steer patients into mail-order pharmacies or pharmacies owned by the PBM, allowing for higher reimbursements for pharmacies and offsetting the cost by directing rebates to taxpayers, and ensuring that community pharmacies have the full opportunity to compete with the PBMs.  

Another key aspect of H.R. 4199 is that it will identify pharmacists as Professional Health Care Providers. Patients will also be able to visit the pharmacy of their choice and assures that every pharmacy has the right to participate in any network.

The PHARMACY Bill is designed to create cost-savings for consumers and the federal government. One of the key provisions of the legislation would eliminate spread-pricing, where the PBM charges a plan one price and reimburses a pharmacy much less. Those savings come back to the plan and lower costs to all consumers.

In order for this historic legislation to continue gaining momentum, we need your help. Join us in rallying members of Congress by spreading the word about H.R. 4199. We also need a companion bill in the Senate. The best way to get this is to contact your Congressional representation through the Capitol Switchboard at 202.224.3121 and ask them for their support. You can also click here to find your representation online.  Help us spread the word!