Looking for Leadership from HHS Secretary Nominee Alex Azar on Requiring Transparency from Big PBMs and Reducing Specialty Medication Costs for Sick Seniors

Nov 17, 2017 · Advocacy


WASHINGTON, D.C. (November 16, 2017) – President Trump’s new nominee for Health and Human Services (HHS) Secretary, Alex Azar, served as the keynote speaker for the National Association of Specialty Pharmacy (NASP) annual meeting in Washington, DC this fall. There, the healthcare veteran provided nearly 1,200 specialty pharmacy professionals with an engaging discussion around developments in the specialty pharmacy ecosystem, including the evolution of the market, impact of specialty pharmacy on patients, and national legislative and regulatory policy.

“I hope to inspire ongoing innovation and top-notch patient support from specialty pharmacy’s industry leaders,” said HHS Secretary nominee Alex Azar ahead of his keynote address. “Specialty pharmacies and pharmacists are the best when it comes to providing the ground-breaking drug therapies, resources and white-glove services that sick Americans need and deserve to live their best lives.”

Following President Trump’s formal nomination of Alex Azar for the top HHS post, NASP Executive Director Sheila Arquette released the following statement:

“We were inspired by Alex Azar’s keynote address at NASP’s annual meeting this fall. While serving as Eli Lilly’s US chief, Azar was responsible for the product launch of Taltz, and a driving force behind the company’s commitment to advancing research to address the unmet needs of people living with dermatologic diseases. He understands the critical role that specialty pharmacy plays for the millions of Americans suffering from some of the most devastating and complex diseases, and who depend on specialty pharmacists to deliver knowledgeable, skilled and caring services to help them manage their sickness.

“Going beyond dispensing medications to help patients manage challenging and complex diseases, specialty pharmacies provide unparalleled patient support services to help sick patients follow the medical treatment prescribed by their doctors, which has been proven to lower overall healthcare costs by improving outcomes through better compliance and disease management.

“If his nomination is approved, we hope Azar will use his platform as HHS Secretary to shine a much-needed spotlight on big PBMs and require transparency across the health care delivery system so we can work together to finally contain runaway prescription medication costs for sick Americans who need it the most.

“Particularly, we hope Azar will address Direct and Indirect Remuneration (DIR) fees, Any Willing Pharmacy Provisions that are neither reasonable nor relevant, and the absence of Medicare Part D minimum network adequacy standards for specialty pharmacies. These efforts will re-focus the benefits of the Medicare Part D program on the beneficiaries the program was designed to protect and away from the first-tier entities contracted to administer the program.

According to a new analysis by the Kaiser Family Foundation, 1 million Medicare beneficiaries had out-of-pocket drug spending above the Part D catastrophic threshold in 2015. These 1 million enrollees spent an average of over $3,000 per person out-of-pocket on prescriptions, $1,215 of which was above the catastrophic threshold. Unfortunately, the number with such high spending has risen sharply in recent years.

IMS Health data shows drug spending continues to shift from traditional to specialty medicines, with specialty share of net spending increasing from 23.6% in 2007 to 42.9% in 2016. A recent paper published in JAMA Internal Medicine confirms that, due to the structure of the Medicare Part D benefit design, rebates and remunerations – including DIR fees – actually increase patients’ out of pocket costs. The paper’s author, Dr. Peter Bach, calls Medicare’s current system “absolutely devastating for people on high-cost specialty drugs.”

Federal investigators in Washington have begun examining the issue, as well. In September, U.S. HHS Office of Inspector General (OIG), whose job is to investigate areas where they believe fraud and abuse may be occurring, announced it is investigating “Part D sponsors reporting of DIR.” Meanwhile, in the absence of legislative action in Washington, states across the country have been trying to pass legislation to require more transparency from PBMs.

National Association for Specialty Pharmacy (NASP) | NASP represents over 50 healthcare industry leaders, working on behalf of retail and specialty pharmacies, drug distributors and hospital systems on legislative and regulatory efforts for the association, which has 250 member pharmacies. To spotlight the increasingly negative consequences of DIR fees, NASP launched StopDIRfees.com with information and testimonials on how big PBMs impose DIR fees to rig the Medicare system. The site also features an online petition and contact information for constituents to call or write elected officials, urging them to stop DIR fees. NASP was founded in 2012 and is the only national trade association that represents specialty pharmacy, serving as the leading educational resource and national advocate for specialty pharmacy healthcare professionals and patients alike. In addition to providing medications to severely ill patients, specialty pharmacy also features support programs and services to ensure patients maximize the benefit from their medication, therapies and services, working to ease the treatment burden for patients, families and caregivers as they work to manage these tough conditions.

MEDIA CONTACT:  Maureen Shanahan | mshanahan@skdknick.com | 407-620-6046

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