NASP Applauds the Introduction of Bipartisan Legislation to Reduce Drug Costs and Support Medication Access for Seniors with Life-Threatening Specialized Conditions

May 27 · Advocacy

WASHINGTON, DC – This week, a bipartisan group of lawmakers in the U.S. House and Senate introduced legislation to rein in the high cost of prescription drugs and support the needs of specialty pharmacy patients living with life-altering and life-threatening specialty medical conditions. The Pharmacy DIR Reform to Reduce Senior Drug Costs Act will ensure that medication savings are passed along to seniors and that these savings are not otherwise used to manipulate drug costs under Medicare Part D or to disadvantage the specialty pharmacies serving patients who have such conditions as cancer, multiple sclerosis, hemophilia, or HIV.

“NASP is pleased that bipartisan champions in the Senate under the leadership of Senators Jon Tester (D-MT), Shelly Moore Capito (R-WV), Sherrod Brown (D-OH) and James Lankford (R-OK); and in the House under Representatives Peter Welch (D-VT), Morgan Griffith (R-VA), Vincente Gonzalez (D-TX), Buddy Carter (R-GA), Raja Krishnamoorthi (D-IL), John Rose (R-TN), Abigail Spanberger (D-VA), and Diana Harshbarger (R-TN) are focused on protecting  specialty pharmacy patient needs. Advancing this legislation will be a victory for patients, specialty pharmacies, the Medicare program and ultimately taxpayers. High drug costs and anticompetitive business practices that threaten specialty pharmacy’s ability to care for their patients risks lives and significantly drains Medicare and taxpayer resources. Barriers to access and affordability force some seniors to forgo the medications they need, resulting in life threatening consequences and increased Medicare costs through preventable hospitalizations and medical complications. We look forward to working with the House and Senate to pass this much needed and commonsense bill,” said Sheila Arquette, NASP President & CEO. 

Pharmacy DIR fees have grown excessively over the last several years.  A 2020 report from Drug Channels showed that pharmacy DIR fees grew from $229 million in 2013 to an estimated $9.1 billion in 2019.  In its own review of pharmacy DIR fees in 2018, the Centers for Medicare and Medicaid Services (CMS) attributed the growth of pharmacy DIR fees to the use of health plan-established performance assessments of pharmacies, showing fees based on measures increased by 225% from 2012 to 2017.  The performance measures today are largely focused on the work of retail pharmacy not specialty pharmacy and, are therefore, not based on the drugs a specialty pharmacy dispenses or disease states a specialty pharmacy manages.

 “As Congress and the Biden Administration seek to address the affordability of life-changing and often life-saving prescription drugs, we must ensure we focus on seniors living with severe and complex medical conditions that require treatment with specialty medications. For far too long, these seniors have been shouldering the brunt of fees that threaten continued access to the critical patient care support services these specialty medications require and patients deserve. The Pharmacy DIR Reform and Reducing Seniors Drug Costs Act will work to change course, protecting access to specialty medications, fairly and appropriately assessing pharmacy performance measurement, and reducing cost sharing for seniors across the country. The National Association of Specialty Pharmacy (NASP) urges Congress to act on this important bill this year.”

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The National Association of Specialty Pharmacy (NASP) is the only national association representing all stakeholders in the specialty pharmacy industry. NASP members include the nation’s leading specialty pharmacies, pharmaceutical and biotechnology manufacturers, group purchasing organizations, patient advocacy groups, integrated delivery systems and health plans, technology and data management vendors, logistics providers, wholesalers/distributors and ​​​practicing pharmacists, nurses, and pharmacy technicians. With over 135 corporate members and 1,800 individual members, NASP is the unified voice of specialty pharmacy in the United States.