Alexandria, Va. - October 11, 2011
The National Community Pharmacists Association (NCPA) today released results from a survey of over 800 independent community pharmacists about the negative consequences for their patients and their businesses if diabetes testing supplies under Medicare Part B are subjected to competitive bidding prices.
The U.S. Centers for Medicare and Medicaid Services (CMS) has indicated that by 2016 providers of these supplies (including testing strips, monitors, lancets, glucose control solutions) will either have to accept prices established under the mail order competitive bidding process or competitively bid in order to continue participating in the Durable Medical Equipment, Orthotics, Prosthetics and Supplies (DMEPOS) program. In July 2011, the average retail single payment amount for diabetes testing supplies was $37.67, whereas the Round 1 Competitive Bidding Program single payment amount for was January 2011 was $14.62.
"The message from our survey is clear: applying competitive bidding prices for diabetes testing supplies to independent community pharmacies is financially unsustainable for these pharmacies and will hurt seniors," said NCPA Executive Vice President and CEO B. Douglas Hoey, RPh, MBA.
"Community pharmacists are indispensable to helping combat diabetes, whether it is the counseling they offer, the medications they dispense, the lifestyle modification classes they provide, or the testing supplies they carry," Hoey added. "But that dynamic will be harmed if these small business pharmacies are forced to walk away from a pricing structure that only a large warehouse can make work. Such a mass exodus of community pharmacies from Medicare Part B would diminish seniors' access and the health complications that could ensue will only increase overall health costs."
The survey of 800-plus community pharmacists, conducted in September and October 2011, produced the following results:
Eighty-one percent reported that their average Medicare diabetes patient visits their independent community pharmacy 2 or more times per month for counseling and/or diabetes testing supplies.
Eighty-four percent of community pharmacists surveyed said they would likely drop out of the program if forced to take reduced payments or competitively bid.
If their patients were forced to obtain diabetes supplies by other means, 84 percent of pharmacists said their patients would suffer a significant impact.
The overwhelming majority (81 percent) of independent community pharmacies regularly deliver diabetes testing supplies to patients (often free of charge) with 28 percent making 30 or more deliveries per month. Without that home delivery and counseling from a community pharmacist, 65 percent of pharmacists predicted a significant impact on these patients, many of whom are homebound.
One pharmacist surveyed noted, "Like many independents, we really only participate because of the patients, not because of profit. We get most new patients because they are tired of the waste from mail-order." Another added, "Due to my patient's disabilities, they need not only delivery, but consultation in order to achieve compliance."
The survey provides further evidence of the need for H.R. 1936, The Medicare Access to Diabetes Supplies Act, introduced by U.S. Representatives Aaron Schock (R-Ill.) and Peter Welch (D-Vt.) and strongly supported by NCPA. The bill permanently exempts diabetes testing supplies furnished by independent community pharmacies (defined as 10 or fewer privately owned stores) from competitive bidding and also permits these pharmacies to continue providing home delivery without being subject to competitive bidding costs.
"Patients complain to pharmacists of having closets full of excess supplies from mail order facilities, which arguably would become even more prevalent if this facet of Medicare Part B was effectively converted into a mail order program," said Hoey. "Judging by the high rate of patient-pharmacist contact reported in our survey, the loss of face-to-face interaction would likely prompt inaccurate glucose readings, giving some patients a false alarm or a misguided sense of security – either of which can lead to higher utilization of more expensive health care options."
The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 23,000 independent community pharmacies. Together they represent a $93 billion health care marketplace, dispense over 37% of all retail prescriptions, and employ more than 315,000 people, including 62,400 pharmacists. Independent community pharmacists are readily accessible medication experts who can help lower health care spending. They are committed to maximizing the appropriate use of lower-cost generic drugs and reducing the estimated $290 billion that is wasted annually by improper medication use. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.
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