This indispensable service comes at a cost. Does Congress care?
By Kimberly Marsela | McKnight’s Long Term Care News
For more than two years now, pharmacists who are the sole provider of prescriptions for the nation’s most vulnerable, often chronically ill patients have begged Congress for relief from a potentially devastating pricing change.
There’s a bill on the table. It has bipartisan support.
And yet, a solution may not come in time for America’s long-term care pharmacies.
New Medicare prices for 10 drugs — most of them very widely used by nursing home residents — kick in Jan. 1. While those better prices will be a boon to community-dwelling seniors, those who call nursing homes and assisted living facilities home might actually lose access to pharmacists and, in turn, the drugs they need.
That’s because the much lower prices disrupt the pricing model long-term care pharmacists have long depended on to offset the costs of added services (think medication management, safety packaging and more) that they essentially provide for free on many low-cost or generic scripts.
Earlier this year, 85% of long-term care pharmacies said they would limit essential services and 60% would close locations if Congress didn’t do something to prop up their businesses.
A core group in Congress has proposed a solution that would go a long way to patch the pricing gap: Their bill established a $30 add-on payment to LTC pharmacies for each Medicare Part D prescription dispensed in 2026 and 2027.
But amid the shutdown and a focus on other highly partisan topics, neither chamber has acted.
Watch the video here
This week, the Senior Care Pharmacy Solution launched a rightfully dark ad campaign, aiming to guilt Congress into action.
“Without urgent action from Washington, millions of America’s most vulnerable seniors could lose access to their prescription medications, unintended consequences stemming from a recent drug pricing law, threaten the viability of long term care pharmacies, and could force many pharmacies that serve nursing homes to close,” a voiceover warns. “This crisis would put access to life saving medications and essential pharmacy services for seniors at grave risk. Washington must act to protect America’s seniors and avert a pharmacy crisis in our nursing homes.”
Like many healthcare issues, it’s not a simple one to understand. ATI Advisory took a deep dive this fall to deliver policymakers key insights and see what it would take to make LTC pharmacists whole, or keep them closer to it.
There’s no dearth of information on the issue, but maybe arguments for the service fee have felt too cold or too removed. Now, SCPC is trying to focus lawmakers on the people who will be most impacted by failure to act: frail seniors whose medication regimens are complex and often costly — but also indispensable.
Read the full article on the McKnight’s Long Term Care News here
Recent Posts
-
Long-Term Care Pharmacy Crisis Hits Nursing Homes
When Congress passed the Inflation Reduction Act in 2022, part of the goal was to lower prescription drug costs for Medicare patients. For millions of seniors in nursing homes and assisted living facilities, though, a little-noticed side effect of that law is starting to hinder their access to those drugs.
-
SCPC Applauds HHS OIG for New Report Highlighting Vertical Integration of Part D Sponsors with PBMs
“Long-term care pharmacies play an essential role in the Medicare Part D ecosystem and impacts to these pharmacies need to be considered with any trends seen in the marketplace. SCPC applauds HHS OIG for its work to analyze and share factual insights into vertical integration of Part D sponsors with pharmacy benefit managers (PBMs) and […]
-
LTC Pharmacy Has a Visibility Problem. Here’s How SCPC’s New CEO Plans to Fix It
Long-term care (LTC) pharmacy is an unsung hero among the healthcare sector’s many players. But a critically important one for our loved ones in nursing homes and assisted living facilities across the country.
Stay in the Know
Get the latest news and updates on issues impacting the long-term pharmacy community.