Washington, DC, Dec. 18, 2024 (GLOBE NEWSWIRE) — The National Association of Specialty Pharmacy (NASP) applauds bipartisan leaders in the House and Senate for their hard work to include crucial statutory PBM-related reforms in the Continuing Resolution before Congress this week. The reforms comprise long-fought NASP priorities to protect specialty pharmacies and patient access to the specialty pharmacy of their choice. It has never been more important for Congress to act and pass these reforms into law. Specialty pharmacies have sought to address these issues for many years, while being forced out of Part D networks.
If passed into law, the legislation will require the Administration to ensure Plan/PBM agreements with specialty pharmacies and other pharmacies are reasonable and relevant under Medicare Part D, overseeing and enforcing such protections. The legislation will also ban the practice of spread pricing by PBMs in Medicaid Managed Care, and work to establish Medicaid Managed Care payment protections for pharmacies.
Ultimately, these legislative protections support Medicare and Medicaid Managed Care beneficiaries who live with chronic complex conditions like cancer, multiple sclerosis and rheumatoid arthritis. Importantly, the reforms will ensure that Part D and Medicaid Managed Care patients can continue to see the specialty pharmacy of their choice, avoiding disruptions in their care.
“For years specialty pharmacies have asked Congress, the Trump and Biden Administations and the Federal Trade Commission to act to address anticompetitive practices like below-cost drug reimbursement and intentionally unfair network terms that are only meant to exclude specialty pharmacies from participation,” says Sheila Arquette, NASP President and CEO. “This legislation would result in direct statutory protections to address our concerns at a critical time as more specialty pharmacies face financial and other unfair network pressures. We urge Congress to stay the course and pass these reforms into law before the end of the calendar year.
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NASP represents all specialty pharmacy industry stakeholders. Specialty pharmacies serve communities of patients who have complex health conditions like cancer, rheumatoid arthritis, multiple sclerosis, cystic fibrosis, hemophilia, organ transplantation and rare diseases. Specialty pharmacies are accredited by an independent, third party nationally recognized accreditation organization ensuring consistent quality of extensive drug management and clinical patient care services.
