[Congressional Record Volume 153, Number 176 (Wednesday, November 14, 2007)]
[Extensions of Remarks]
[Page E2419]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      THEY CANNOT DO BUSINESS LIKE THIS--PHARMACISTS NEED OUR HELP

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                            HON. JERRY MORAN

                               of kansas

                    in the house of representatives

                      Wednesday, November 14, 2007

  Mr. MORAN of Kansas. Madam Speaker, I rise tonight to call upon 
Democratic leadership to bring legislation to the floor that will help 
our independent pharmacies stay in business. The last few years have 
been difficult for pharmacists across the United States, and many are 
struggling to keep their doors open due to changes in the Medicare Part 
D prescription program. In my Kansas district alone, we have lost four 
pharmacists since this government program went into effect.
  Once again, we are asking pharmacists to bear the burden of our cost-
cutting measures. The Deficit Reduction Act of 2005 made average 
manufacturers price, AMP, the new basis for the Medicaid Federal upper 
limit on multi-source, generic prescription drugs. Earlier this year, 
the Government Accountability Office released a report indicating that 
this new pricing system would reimburse pharmacists at 36 percent below 
what it costs them to buy the prescriptions. I ask you, how can we 
realistically expect anyone to do business like that?
  We need to make changes quickly; otherwise, these pharmacies will no 
longer be around to serve customers. Here are some real life examples 
of Kansas pharmacists who are going to be negatively affected by this 
change if we do not act soon.
  Many Medicaid patients in Kansas are in treatment for psychiatric 
conditions. Because of their mental state, they often forget to take 
their medications. Mike Conlin, a pharmacist in Topeka, has initiated a 
program in his pharmacy to help his psychiatric patients remember to 
take their medications by having his staff put the meds in a unit 
dosage device. This device allows his patients to see at a glance which 
medications are called for at any particular time of day. Mike stated 
it will be difficult to offer this individual treatment on a medication 
that pays him nearly 36 percent less in reimbursement than it actually 
costs his drugstore.
  In other parts of the State, a great number of our community 
pharmacists double as the local nursing home pharmacist. Jim Hampton, 
of Atwood, Kansas, is one such pharmacist. The physicians and staff of 
the local Atwood home, depend on Jim to advise them daily on such 
issues as drug-to-drug interactions, new drugs and dosage regimens. 
While Jim finds great satisfaction in providing these medications and 
advice on their usage, he must reconsider his ability to serve these 
geriatric and developmentally disabled patients. And his decision is 
purely a business decision. Jim will be forced to decide whether his 
business can really afford to remain viable in selling a product for a 
price far less than he can acquire that product. Average manufacturer 
pricing is forcing Jim to do just that. And the ramifications of Jim's 
decision are far reaching.
  In Phillipsburg, Kansas, there is a young disabled mother that 
recently gave birth to a child with a heart condition. She was without 
her Medicaid card yet urgently needed medication for the newborn 
infant. In fact, she was without a medical card of any type showing 
that insurance would pay for the medication. The local pharmacist, Rob 
Wenzl of Wenzl Drug, provided the infant her lifesaving drug. Rob did 
this despite the fact the new mom had no proof of coverage. Rob is just 
one more of many pharmacists in rural Kansas that are being forced to 
consider letting go of their Medicaid patients. The personalized 
service that Rob enjoys providing his patients, and that personalized 
care the patients receive, will potentially be eliminated should 
average manufacturer pricing as currently written be foisted upon our 
pharmacists.
  Those of us in Congress take our responsibility seriously to stand up 
for those who are in trouble. I encourage my colleagues to listen to 
those pharmacists in their districts and encourage Democratic 
leadership to bring legislation to the floor to fix this problem.
  Access to local pharmacies is important to a strong healthcare system 
and is, therefore, important to each and every one of us.

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