SCPC Calls for Immediate Congressional Action to Fix Broken LTC Pharmacy Payment Model as More Drugs Become Subject to Mandatory Medicare Price Negotiations

DATE: January 17, 2025

The Senior Care Pharmacy Coalition (SCPC), the leading national voice for the long-term care (LTC) pharmacy community, released a statement on the newly released Medicare drug price negotiations from the Biden Administration on the next 15 drugs:  

“Today, the Biden administration announced the next 15 drugs that will be subject to Medicare price negotiations, which include another 10 medications often utilized by patients in long-term care (LTC). This decision means the majority of the 25 drugs selected so far – 8 of 10 in 2026 and 10 of 15 in 2027 – will have a direct and substantial impact on the ability of LTC pharmacies to continue providing essential care services, underscoring the urgent need for Congress to act. Lawmakers must address the unintended consequences of this new policy and the severe impact it will have on both LTC pharmacies and the unique patient population they serve.  

“The Part D pharmacy payment model is broken, forcing LTC pharmacies to dispense medications significantly below their own costs while allowing Part D Plans and PBMs to reap massive profits at their expense.  

“The first round of 10 drugs subject to Medicare price negotiations already included eight medications frequently used by patients in long-term care. Adding another 10 to the list under the current Medicare payment model will only further exacerbate the dire situation facing LTC pharmacies and patients. Seniors in nursing homes and assisted living facilities amongst other long-term care settings depend on LTC pharmacies to provide 24/7 essential pharmacy services –longstanding services now facing disruption, particularly for small pharmacies serving rural areas.  

“SCPC and its members having been sounding the alarm on this critical issue through the organization’s Save Senior Rx Care campaign. Congress must now act before it’s too late and pass corrective action before the first round of drug prices takes effect on January 1, 2026,” said Alan Rosenbloom, President and CEO of SCPC.  

More information on the impact of Medicare drug price negotiations on LTC pharmacies and the solution Congress must adopt are available at https://seniorcarepharmacies.org/policy-priorities/.   

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