AMP...Loose Ends?

The NCPA/NACDS Federal Court injunction bought us some time (about 6 months to a year) until we are able to provide a fix for AMP (Average Manufacture Price). This is the time we need to utilize our resources, pull together, and FIX AMP before it “fixes” us. Even though we need to work towards the AMP FIX goal, it is unlikely that S.1951/ H.R.3700 will get pushed through Congress this year. The physician Medicare fee cuts are coming up at the end of June and this is perhaps what we can “tie” another delay to. I know it seems kind of cheesy to delay only to delay again, but the alternative is much worse. Basically, if there isn’t time to fix AMP and find a large piece of legislation to “tie” it to in which to get through Congress (ie: Medicare package), then a delay is what we need for the time being. We already have Baucus and Tester on board in our Senate, we must have Congressman Rehberg on board as well. HR3700, the `Fair Medicaid Drug Payment Act of 2007' in the House of Representatives, is the exact same bill as Baucus’s S.1951 in the Senate. By the way Senator/ Presidential Candidate Barack Obama [IL] is a co-sponsor of S.1951 and S.1954 since 12/03/07.

Rehberg has been a wonderful supporter of community pharmacy but we need his help now more that ever! Bring these points to his attention: (Please also visit www.grizrph.com/spotlight.htm for more information on this important pharmacy legislation including SAMPLE LETTERS)

The devastating effects of AMP if implimented:
1. The Government Accountability Office (GAO) identified the reimbursement on average is 36% less than the acquisition costs for generic medications
2. Director of the PRIME Institute at the University of Minnesota, argued that with the 250% of AMP rule, as many as 10,000 to 12,000 pharmacies in rural and underserved urban communities would close, causing irrevocable harm
3. President Bush’s 2009 Fiscal Budget includes another 1.1 BILLION in cuts from pharmacy reimbursement which would equate to 150% of AMP not just 250% of AMP which would seal all our fates if ever enacted.
4. According to NCPA and CMS, community pharmacies would lose $5.5 million a day under the rule as written.

Why H.R.3700 and S.1951:
1. Remove mail order transactions and certain other discounts, rebates, and price concessions from calculation of AMP
2. Base pharmacy payment on average AMP, instead of the lowest AMP
3. Apply the AMP formula only when three or more alternatives are available, instead of two or more
4. Raise Medicaid payment to 300% of AMP instead of 250%
5. Require prior authorization for brand name drugs that are more expensive than other biologically and therapeutically equivalent drug products
6. Senator Baucus, the chair of US Senate Committee on Finance, and Representative Pallone, the chair of the Subcommittee on Health in the Energy and Commerce Committee, are in strong positions to move their respective legislation.
7. Make sure to ask him to co-sponsor H.R.3700 as well as attach a delay to the June 30th physician Medicare cut bill.
8. Don’t forget to thank him for his support on H.R.971, and H.R.1474.


Sample letter to Congressman Rehberg (HR 3700) ; Bag Stuffers for loyal customers; Contacts for Congressman Rehberg.