NACDS: “For consumers on tight budgets who rely on third-party drug discount cards to pay for their medications, the potential loss of access to these discounted medications would be devastating”
National Association of Chain Drug Stores (NACDS)
The NACDS was founded at 1933. NACDS focuses on advocating for pro-patient and pro-pharmacy public policy; communicating the value of community pharmacy as the face of neighborhood healthcare; and fostering business community and solutions through effective meetings and other member programs.
At the 12 of August NACDS stated that certain state Medicaid programs have attempted to include third-party drug discount card in their U&C definitions. According to letter the third-party discount system were created to help consumers access affordable medication in the absence of adequate insurance coverage, several companies operate – and almost all pharmacies participate in – third-party discount programs that enable customers to obtain better pricing for prescription drugs than the pharmacies’ usual retail prices.
“Although consumers pay out of pocket when using third-party discount cards, the price returned to the pharmacy by the third-party discount-card operator during adjudication is not the price that the pharmacy usually charges the general public.
The pharmacy only facilitates the lower prices made available by the third-party card operator to customers who present the card. Indeed, the pharmacy stands operationally and financially in the exact same position as it does with beneficiaries of other third-party payers, such as health insurers and governmental entities.” reported NACDS President and CEO Steven C. Anderson
Besides, in its letter, the association refers to the President Trump law the “Know The Lowest Price Act”.
“Know The Lowest Price Act”
“Know The Lowest Price Act” was passed in 2018. This bill prohibits a prescription drug plan under Medicare or Medicare Advantage from restricting a pharmacy from informing an enrolled of any difference between the price, co-payment, or coinsurance of a drug under the plan and a lower price of the drug without health-insurance coverage. (Such restrictions are commonly referred to as gag clauses.)
In addition to the already mentioned law, NACDS cited many other federal laws, regulations and guidance with opposed to the inclusion in “usual and customary” the pharmacy charges.
“Critically, if state Medicaid programs include third-party discount cards in calculations of [usual and customary], pharmacies may be financially unable to continue to accept third-party discount cards. For consumers on tight budgets who rely on third-party discount cards to pay for their medications, the potential loss of access to these discounted medications would be devastating.
Elimination of an option that provides lower-priced medication to the underinsured and uninsured would directly contravene the Administration’s policy to promote affordable access to prescription drugs,” wrote in his letter Anderson.