In the News

Any lower drug prices that result from White House efforts to negotiate on behalf of Medicare beneficiaries may lead to short-term gains for nursing homes, but there also could be a steep price to pay in the long-term, experts warned this week. The Centers for Medicare & Medicaid Services on Tuesday announced the first 10 drugs covered by Medicare Part D that will be included in negotiations running through 2024. They are all commonly prescribed drugs that treat conditions ranging from diabetes to arthritis and heart failure.

Following the Biden Administration’s bid this week to reduce the price of certain drugs – many of which are commonly used in nursing homes – experts are cautioning that the changes may negatively impact the bottomline of organizations in the sector. As Medicare Part D price negotiations for these drugs come into focus this week, the Senior Care Pharmacy Coalition (SCPC), for one, is warning that changes to Part D might cause “collateral damage” to long-term care pharmacies, the patients they serve and operator partners.

Long-term care pharmacies say the kick-off of Medicare drug price negotiation Tuesday (Aug. 29), while well-intentioned, will inadvertently hurt them and their patients unless policy makers also move forward on pharmacy benefit manager and Part D payment reforms. “Long term care pharmacies are likely to be collateral damage,” Alan Rosenbloom, president and CEO of the Senior Care Pharmacy Coalition, told Inside Health Policy.

Federal regulators and policy makers have increasingly coaxed long-term care patients and services to migrate more to home- and community-based settings in recent years. Now it’s time to allow long-term care pharmacists to do the same, without barriers that have been imposed by lawmakers for years, according to new study findings from the Senior Care Pharmacy Coalition (SCPC) and healthcare analysis firm ATI Advisory.

The Senior Care Pharmacy Coalition (SCPC), the only Washington-based organization exclusively representing the interests of long-term care (LTC) pharmacies, has responded to a Sen. Bill Cassidy (R-LA)-led May 2023 Discussion Draft of legislation to improve care for enrollees dually eligible for the Medicare and Medicaid (dual eligibles) programs. Senators Carper (D-DE), Cornyn (R-TX), Menendez (D-NJ), Scott (R-SC), and Warner (D-VA) joined Senator Cassidy in this effort.

SCPC President and CEO Alan Rosenbloom speaks with the Pharmacy Podcast Network the importance of advocating for PBM reform​, the status of ​the LTC Pharmacy Definition ​Act​, LTC Pharmacy ​at-home​, ​d​rug pricing legislation ​and its​ implications for LTC Pharmacy, and more.

Across all cultures and generations, caregivers have long served an integral role supporting the health of family members’ or friends in need of long-term care (LTC). In many cases, these caregivers are unpaid individuals without formal training — often a spouse, partner, family member, friend or neighbor.

Despite the purported value of pharmacy benefit managers (PBMs), drug prices remain unaffordable for many Americans (“Prescription drug pricing reform must rein in pharmacy benefit managers,” Web, Oct. 18). As middlemen between the manufacturers, pharmacies and consumers, PBMs are notorious for abusive business practices that impact both patients’ wallets and their access to prescription drugs, while gouging unaffiliated pharmacies.

One of the three dominant U.S. pharmacy benefit managers (PBMs)—the middlemen that handle the vast majority of prescription drug plans in the United States—has instituted a scheme that has left roughly 400,000 active-duty and retired military households scrambling for a new pharmacy provider within the next week. Critics say the maneuver is a naked attempt by Express Scripts, the Cigna-owned PBM, to steer beneficiaries toward its own market-leading mail-order pharmacy.