JEFFERSON — Seeking to expand Medicare beneficiaries’ access to pharmacies, local pharmacist Bill Monroe of Medicap Pharmacy is urging the U.S. House of Representatives to pass H.R. 4577, The Ensuring Seniors Access to Local Pharmacies Act, which was introduced by Reps. Morgan Griffith (R-Va.) and Peter Welch (D-Vt.). The bill allows “any willing pharmacy” located in a medically underserved area to have the opportunity to participate in all Medicare Part D drug plan networks, including those that have a “preferred pharmacy” network.
Each year more Medicare Part D plans are imposing financial penalties on beneficiaries for using many local community pharmacies. These “preferred pharmacy” plans are often deceptively marketed to seniors, many of whom are surprised to discover the limits placed on their choice of pharmacy. As a result, many beneficiaries have to either pay higher co-pays, drive considerable distances (past more convenient and trusted community pharmacies) to reach a “preferred” pharmacy, or use impersonal mail order. H.R. 4577 rectifies this unnecessary problem.
“A functioning free market is based on business competition, but that’s not the case with Medicare Part D’s preferred pharmacy plans,” said Monroe. “If I am willing to accept ‘preferred’ pharmacy contract terms and conditions, I should be able to continue providing seniors with their medications, medical advice and other services that help maximize their health outcomes. Unfortunately, restricted networks undermine patient choice and sideline independent community pharmacies like mine.”
Monroe added, “My primary concern is for patients. America wastes as much as $290 billion a year because of the improper use of medication, which means any efforts to boost better medication adherence should be embraced. Considering that research indicates the biggest predictor of medication adherence is a patients’ personal connection with a pharmacist or pharmacy staff, and independent community pharmacies rate the highest in that regard, why exclude them from having the opportunity to participate? Not only should the U.S. House of Representatives work to pass H.R. 4577, but the U.S. Senate should introduce and pass a similar bill.”
Enacting H.R. 4577 into law is the right approach for several other reasons.
- First, increased pharmacy choice will give consumers more options to select a pharmacy based on competitive factors such as cost to the patient, customer service and quality.
- Second, many Medicare beneficiaries in less populated areas will not have to travel 20+ miles to reach a “preferred” pharmacy if they want to avoid the higher co-pay charge.
- Third, seniors with specific needs, including those for whom English is a second language, can continue relying upon the personalized care of independent pharmacies, as evidenced by the patient and pharmacy profiles posted at www.ncpanet.org/pharmacychoice.