Today, Rep. Tom Suozzi (D – Long Island, Queens) met with health care experts and members of the National Association of Specialty Pharmacy (NASP) at Onco360, where he toured the independent specialty pharmacy and visited with constituents from New York’s 3rd Congressional District in Great Neck, Long Island. Rep. Suozzi, Vice-Chair of the bipartisan “Problem Solvers Caucus,” was one of 54 members of Congress to cosign a bipartisan letter to the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), strongly urging Acting HHS Secretary Don Wright and CMS Administrator Seema Verma to ensure rebates and discounts in Medicare Part D help contain skyrocketing out-of-pocket costs for patients. The letter also advocates to ensure patient and prescriber access to the specialty pharmacy of their choice, instead of limited access resulting from the application of DIR fees that are tied to inapplicable performance metrics, aligning with the Medicare Part D Star Rating measures rather than the disease being treated by the prescribed specialty drug.
“New York’s Onco360 and members of the National Association of Specialty Pharmacy are working hard to deliver the best quality care to achieve the best possible clinical outcomes for patients and caregivers managing cancer, along with other diseases that require specialty medications,” said Rep. Tom Suozzi (NY3). “Medicare Part D has achieved impressive results over the last 14 years, but skyrocketing prescription drug costs are taking a serious toll on sick seniors. HHS and CMS must work harder to contain out-of-pocket costs for sick seniors, and ensure they receive the specialty medications they need while living with complex, life-altering, or life-threatening diseases.”
According to IMS Health data, drug spending continues to shift from traditional to specialty medicines, with specialty share of net spending increasing from 23.6% in 2007 to 42.9% in 2016. Specialty medications are used to treat patients with serious, chronic, rare, progressive, or debilitating or fatal if left untreated or undertreated. Examples of these illnesses include cancer, hepatitis C, infectious disease, infertility, Crohn’s disease, rheumatoid arthritis, psoriasis, HIV/AIDS, multiple sclerosis, Cystic Fibrosis, organ transplantation, human growth hormone deficiencies, hemophilia, and other bleeding disorders.
“We shared a meaningful morning with Rep. Tom Suozzi at Onco360, and we look forward to continuing our efforts to work with Congress and all Federal regulatory bodies to elevate awareness for the differentiated outcomes that specialty pharmacy delivers for patients every day,” said NASP Executive Director Sheila Arquette. “Specialty pharmacies make significant contributions to clinical outcomes for patients, which is why we need to stop big PBMs from imposing fees that inflate prescription drug costs for the sickest, most vulnerable seniors – the very patients the Medicare Part D program was designed to protect.”
NASP represents over 50 healthcare industry leaders, working on behalf of retail and specialty pharmacies, drug distributors and hospital systems on legislative and regulatory efforts for the association, which has 250 member pharmacies like Onco360.
“I want to personally thank Congressman Suozzi for visiting our pharmacy today and for his willingness to discuss ways we can work together to provide cancer patients with the medications they need to fight the terrible disease,” said Onco360 President and CEO Paul Jardina. “Specialty pharmacy provides the high-touch care and support services needed by patients who are diagnosed with cancer, a disease so many Americans have been impacted by. We will continue working with Congress and stakeholders across the spectrum to drive clinical outcomes, and will remain dedicated to keeping patients at the center of all decision-making.”
A recent paper published in JAMA Internal Medicine finds that, due to the structure of the Medicare Part D benefit design, rebates and remunerations – including Direct and Indirect Remuneration (DIR) fees – actually increase patients’ out of pocket costs.
The author of the JAMA paper, Dr. Peter Bach, calls the current Medicare system “absolutely devastating for people on high-cost specialty drugs.” Last month, U.S. HHS Office of Inspector General (OIG), whose job is to investigate areas where they believe fraud and abuse may be occurring, announced it is investigating “Part D sponsors reporting of DIR.”
“The misuse of DIR Fees by PBMs is taking money out of the wallets of our sick and elderly, as well as out of the cash registers of the hard-working community pharmacies who serve them,” said Timothy Ward, President of Hercules Pharmaceuticals, a distributor who services the independent and community pharmacy sector. “We must remove the calibrated distortions which benefit entrenched PBM interests, hurt the patients, and undermine the market.”
To spotlight the increasingly negative consequences of DIR fees, NASP launched StopDIRfees.com with information and testimonials on how big PBMs impose DIR fees to rig the Medicare system. The site also features an online petition and contact information for constituents to call or write elected officials, urging them to stop DIR fees.
NASP was founded in 2012 and is the only national trade association representing all stakeholders in the specialty pharmacy industry. The core mission of NASP is to provide educational programs to pharmacists and other healthcare professionals, and to promote specialty pharmacist certification for specialty pharmacy professionals. NASP also serves as an advocate for public policies that ensure patients have appropriate access to specialty medications in tandem with critical services. In addition to providing medications to severely ill patients, specialty pharmacy also focuses on support programs and services to ensure patients realize the maximum clinical benefit from their medication, therapies and services, working to ease the treatment burden for patients, families and caregivers as they work to manage these tough conditions. For more information, visit www.naspnet.org.
CONTACT: Maureen Shanahan | [email protected]