NASP says final Medicare pricing rule failing patients

The US trade group National Association of Specialty Pharmacy (NASP) today expressed its extreme disappointment that the administration did not initiate much needed reforms to ensure Medicare beneficiaries begin paying less at the pharmacy counter in 2020.

This week, the Centers for Medicare and Medicaid Services (CMS) issued a final Medicare Advantage and Medicare Part D Drug Pricing Rule (CMS-4180-F), deciding not to include much needed reforms of abusive Direct and Indirect Remuneration (DIR) fee practices. This after CMS's proposed rule highlighted DIR fee practices by plans and pharmacy benefit managers (PBMs) that result in:  increased costs at the pharmacy counter, quickly pushing seniors into the catastrophic coverage gap; and threatening access to specialty medications for our most vulnerable populations.

"CMS's decision to turn a blind eye is a significant blow to patients seeking relief from the high out-of-pocket costs they face on drugs at the pharmacy counter and is severely out of step with the administration's proactive and ambitious approach to confronting practices that drive up patient and government spending on drugs," said Sheila Arquette, NASP executive director, adding: “NASP is concerned for patients and concerned about the continued impact pharmacy DIR fees will have on independent specialty pharmacy's ability to continue providing life-saving medications and care management services for patients with complex conditions such as cancer, rheumatoid arthritis, multiple sclerosis, cystic fibrosis, and HIV/AIDS."