They say hindsight is 20/20. With the Supreme Court’s ruling on healthcare reform, the luxury of looking back shows that the National Association of Chain Drug Stores and allies took the right course to battle the pharmacy Medicaid cuts of the Deficit Reduction Act. What we learned should inspire pharmacy to remain tenacious in its continued advocacy on this issue and in confronting all other challenges.
No stone was left unturned as NACDS, the National Community Pharmacists Association and others waged an all-branches-and-all-levels-of-government strategy to attack the pharmacy cuts in the DRA that resulted from the average manufacturer price model. That is a good thing, as the cuts would have jeopardized access to pharmacy patient care, resulting in poorer health and increased long-term health costs.
No one could have predicted the complex twists that the battle over the AMP cuts would take after passage in 2006 of the DRA. The fact that a new approach to Medicaid pharmacy reimbursement would be included in a new healthcare-reform law — a law that itself would be the subject of a most unconventional and unexpected Supreme Court ruling — seems to fit the life story of this issue.
AMP’s path involved legal action, due to a lawsuit filed by NACDS and NCPA. It involved action by true friends of pharmacy in Congress who legislated a delay in the cuts. It also involved the use of research, public relations, grassroots mobilization, collaboration with patient advocacy groups, coordination with state government affairs and more.
All of these aspects of the fight led up to the crescendo that we knew all along would be necessary to address the AMP cuts: a change in the law itself. Community pharmacy achieved several improvements to the approach to Medicaid pharmacy reimbursement in one part of the much, much larger healthcare-reform law.
It is imperative that community pharmacy never forget the lesson of what, to this point, has been a six-year battle. Pharmacy worked in united fashion with a sound strategy. It found its voice in communicating the value of pharmacy to external audiences, instead of just preaching to the choir. It did not back down and stood its ground at every pivotal point. It was not deterred by an analysis of the odds, and it was motivated by a passion for patient care that could not be dampened.
However, our effort is far from complete. The implementation phase of the healthcare law will require a great deal of continued engagement by NACDS and its allies. That certainly is true of the executive branch’s implementation of the new AMP provisions. The great AMP debate is not yet over, nor is the larger effort to secure community pharmacy’s rightful place in an approach to healthcare delivery that offers the most promise for patients nationwide.
But when it comes to moving forward, at least pharmacy can find an example of success by looking back at all it already achieved in fighting the AMP cuts and securing much-needed victories for patient care.
Steve Anderson is president and CEO of the National Association of Chain Drug Stores.