HR 4119 is supporting your community pharmacies
Note. This commentary was written by the Association of Community
Pharmacists Congressional Network about HR 4119, which was introduced
into the House of Representatives by Rep. G.K. Butterfield, D-N.C.,
last year. It is co-sponsored by 31 other congressmen, including Rep.
Walter Jones, R-N.C., who represents Dare and Hyde counties.)
The Association of Community Pharmacists Congressional Network (ACP*CN)
is challenging Congress to confront the pharmacy benefit management
(PBM) industry’s hidden fees and abusive practices. According
ACP*CN, PBMs are the primary source of inflated prescription costs and
rising patient anger.
“Members of Congress need to address the secret PBM practices that
pharmacies in their districts have uncovered—PBM corporations are
underpaying local pharmacies, misusing confidential patient
information, and hiding money owed to taxpayers,” stated Mike James,
ACP*CN vice president for government affairs. “The time for
comprehensive congressional action is overdue.”
ACP*CN has helped thousands of pharmacy owners across the nation
provide evidence to members of Congress that PBMs underpay local
pharmacies for prescriptions and then hide the underpayments from
insurers and government plans to inflate PBM profits. The
pharmacies have also provided evidence that PBMs are taking patient
data from community pharmacies and using it to send threatening letters
to their patients. This forces patients into PBM-owned
and mail-order programs instead of local pharmacies patients prefer.
ACP*CN encouraged congressional leaders to introduce HR 4199, the
“Pharmacy Bill” that will end these practices.
The bill will place greater emphasis on use of generic drugs, local
pharmacies, and other significant cost-containment measures to reduce
prescription costs for taxpayers and consumers by more than $250
billion over 10 years, according to a report for ACP*CN by a former
analyst of the Congressional Budget Office. Mark Merritt of
Pharmaceutical Care Management Association (PCMA) responded to the
study by claiming the bill will cost taxpayers $186 billion, and by
telling Congress that pharmacists in local communities are overpaid.
“The typical pharmacy in a local community cares for hundreds of
patients daily and earns a few pennies on the dollar after paying for
inventory, rent, salaries, and other expenses,” according to
James. “By comparison, Mark Merritt earned over $1.2 million
2009 for adding zero-value to patient care. Members of
can decide for themselves who to trust and who is overpaid.”
PCMA has announced a multi-million dollar campaign to defeat HR 4199,
and has dispatched lobbyists to meet with members of Congress in
Washington. As a result, ACP*CN is encouraging pharmacists to
provide their U.S. Representatives with “Three Questions for the PBM
Lobbyist Sitting in Your Office.”
•Why have 60 of the nation’s largest employers recently dropped their
PBMs or forced them to disclose their drug acquisition costs?
Answer: According to one of the companies (Caterpillar), “There was a
great deal of waste inherent in a system that uses PBMs as middle men”
(as reported in CFO.com).
•Why is the House Committee on Oversight and Government Reform pushing
a bill to eliminate PBMs from the Federal Employee Health Program?
Answer: According to Chairman Steven Lynch, D-Mass., “Federal employee
plans (with PBMs) pay substantially more for drugs than other agency
programs,” and “even Costco and Drugstore.com offer better prices for
drugs” (June 24, 2009).
•Who helps taxpayers save more money, PBMs or local pharmacies?
Answer: According to a recent report by Wolters Kluwer Health
Source Pharmaceutical Audit Suite, community pharmacies dispense
lower-cost generics to fill 67 percent of all prescriptions compared to
49.6 percent by PBMs. According to congressional testimony on
June 24, 2009 by Pharmacy Outcomes Specialists, “PBMs often get large
rebates, as much as 50 percent, from drug manufacturers that are never
passed back to the plan sponsor." According to the U.S.
Personnel Inspector General, “PBM contracts…make auditing them almost
insurmountable” (June 24, 2009).
FOR MORE INFORMATION
For more information on the Association of Community Pharmacies
Congressional Network and for information on contacting your
congressmen to support HR 4199, go to
To read HR 4199, go to