While the American Society of Health-System Pharmacists largely supports CMS' proposed policy revisions for Medicare Part D, Medicare Advantage and the program of all-inclusive care for the elderly, or PACE, the ASHP is asking the agency to "change course" on a proposed rule.
In a Jan. 27 letter, the ASHP, which represents 60,000 U.S. pharmacists, pharmacy technicians and student pharmacists, shared concerns with CMS' proposed framework for how it will implement negotiated drug prices.
"Although we support the underlying goals of the IRA's [Inflation Reduction Act] price negotiations, the proposed framework threatens patients by undermining the financial stability of hospitals, pharmacies, and other community providers," the letter said.
In 2022, CMS gained the authority to negotiate with pharmaceutical companies on select Medicare Part D medications. In 2026, it will enforce the first 10 negotiated drug prices.
Instead of lowering drug prices, the agency's proposed implementation will increase drug purchasing costs, according to the ASHP and the National Community Pharmacists Association.
An NCPA survey of independent pharmacies found that 93.2% will not participate in the Medicare Drug Price Negotiation Program or are considering not doing so due to expected financial losses.
The ASHP added that the drafted implementation framework will
- Force providers to purchase medications at an inflated wholesale acquisition cost
- Require providers to finance the higher carrying cost of inventory purchased at inflated prices until rebates are received from the manufacturer
- Create a system where rebates may be significantly delayed or denied at the manufacturer's discretion, and
- Saddle providers with inflated administrative costs to comply with rebate programs that vary from manufacturer to manufacturer and drug to drug.