June Legislative Update
SB 58 Passes, Pharmacy Tech Regs, HB 99, Fed Deficit Reduction...
Kelly Vyzral, Director of Government Affairs
SB 58: Pharmacist Immunization Legislation Passes!!!!
SB 58, which expands the Pharmacy Practice Act in regards to immunization, was voted out of the House and is now on the Governor's desk awaiting his signature! The legislation adds diphtheria, meningitis, and pertussis vaccines to the list of adult immunizations that pharmacists can administer, as well as allows pharmacy interns, under the direct supervision of an immunization-trained pharmacist, to administer the influenza vaccine to adults. The State Board of Pharmacy has already begun drafting rules for its implementation. The legislation was sponsored by Senator Kevin Coughlin (R-Cuyahoga Falls). A big thank you goes to all the pharmacy students who wrote letters to their legislators about the importance of this bill, and to OSU student Jeff Steckman who recently testified before the House Health Committee. They got the message! Please take a couple of minutes to call or write a thank you to Sen. Coughlin for all the work he did in getting this bill passed so quickly. Sen. Kevin Coughlin, Senate Building, Room #137, First Floor, Columbus, Ohio 43215; 614.466.4823; firstname.lastname@example.org.
Pharmacy Technician Regulations
The pharmacy technician bill is still in a holding pattern. We are working closely with the Board of Pharmacy and Sen. Tim Grendell (R-Chesterland) who will sponsor the bill when introduced.
HB 99: Epilepsy Medication
HB 99, introduced by Rep. Michelle Schneider (R-Cincinnati), and SB 114, introduced by Sen. Kevin Coughlin (R-Cuyahoga Falls), would require pharmacists to obtain written consent from the prescriber and the patient before making any substitution of epilepsy medication. This includes brand to generic, brand to brand, and generic to generic.
Under current law, pharmacists are required to verbally notify a patient when a generic substitution is made. Similar bills have been introduced in several states including Nebraska, Texas, Iowa, Pennsylvania, Arizona, and South Dakota. We consider this bill to be one more onerous requirement placed on pharmacists when the situation could be resolved by the prescriber simply writing D.A.W. on the prescription. OPA is opposed to this legislation, which would require the pharmacist to call the prescriber each time a substitution is made. Many of these substitutions are required by the patient?s health plan or third party payer. This could keep patients from getting the medications they need and necessitate multiple trips to the pharmacy. It will also greatly increase the cost to the state in both the employee and retiree health care and state Medicare programs. For every 1 percent shift to generic drugs, the state saves $19 million.
The bill's sponsors have both stated their interest in resolving this through interested party meetings rather than through legislation, and OPA continues to push for a solution involving education and communication. As a reminder, under Ohio law, the pharmacist is required to verbally notify a patient whenever a substitution is made.
Federal Deficit Reduction Act
Another huge issue affecting pharmacy on both a state and federal level is the impending release of AMP (average manufacturer price). Reimbursement proposed under Federal DRA (Deficit Reduction Act) set to take effect July 1, 2007, may pay pharmacies 35 to 65 percent below cost to purchase drugs from the wholesaler, according to the GAO report released January 20, 2007.
If a pharmacy pays a wholesaler $100 for a drug, they may be reimbursed between $35 and $65. Ohio pharmacies could lose $63.22 million over 12 months. Many rural and urban pharmacies with high Medicaid populations would be forced to close. Medicaid and non-Medicaid patients would lose access to pharmacy services, and the State could see a six-fold increase in Medicaid drug costs as pharmacists are forced to dispense more costly brand name drugs.
OPA is fighting on two fronts of the state level to force the state to give back to pharmacy in the form of a dispensing fee increase, any savings it sees from the new pricing system. We are working for an amendment to the budget in the Senate, and we have identified a legislator in the House who has offered to introduce a stand-alone bill that would hold pharmacy harmless when the AMP takes affect in July. We will keep you updated with a bill number and contact information when the legislation is formally introduced.
We would also recommend that you contact your Congressman and Senators in Washington DC, and let them know how devastating this type of under-pricing will be to your business. If you are unsure of your Congressional Representative, you can go to the OPA website and click on legislative information, then click on find your congressman, that will allow you to plug in your zip + 4 and give you the name of your Congressperson.