The National Community Pharmacists Association (NCPA) has expressed approval following the House of Representatives' passage of a budget reconciliation bill. This bill includes provisions aimed at eliminating pharmacy benefit manager (PBM) spread pricing and ensuring transparent reimbursement rates in state Medicaid managed care programs.
B. Douglas Hoey, CEO of NCPA, commented on the development: “While doing nothing to reduce the cost of drugs for Medicaid beneficiaries, spread pricing has been costing federal and state taxpayers hundreds of millions of dollars every year. Through low and underwater reimbursements, PBMs have been systematically squeezing local pharmacies and helping drive them out of business. It’s egregious. Moving to a fairer pharmacy reimbursement system that ends spread pricing and requires transparent, predictable reimbursements to pharmacies is a step in the right direction. We urge the Senate to swiftly pass these provisions and President Trump to sign them into law.”
Spread pricing involves PBMs charging insurance plans like Medicaid one price for prescription medications while reimbursing pharmacies at a lower rate, retaining the difference as profit. The NCPA has long advocated against this practice, seeking a more straightforward payment model that adequately covers dispensing costs.
The reconciliation bill now awaits consideration by the Senate. The NCPA remains committed to advocating for these Medicaid policies and is also pursuing Medicare Part D contract reform within other legislative efforts this year.
Founded in 1898, the NCPA represents over 18,900 community pharmacies across the United States, employing more than 205,000 individuals. These pharmacies are integral parts of their communities and serve as accessible healthcare providers.
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