Pharmacy Groups Say Draft Medicaid FULs Could Lead To Rx Access Issues
Associations representing retail pharmacies say faults in CMS’ draft average manufacturer price-based federal upper limits for multiple source drugs could result in reduced access to drugs by the Medicaid population.
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A proposed rule on the calculation of average manufacturer price issued Jan. 27 addresses numerous complex issues for the pharmaceutical industry in its 200 pages, including a proposal that manufacturers report AMP based on their actual sales to retail community pharmacies or to wholesalers for drugs distributed to retail community pharmacies.
In an interview, National Community Pharmacists Association CEO Doug Hoey expresses concern with restricted pharmacy networks in health plans as well as a lack of clarity about those restricted networks on the Medicare Part D Plan Finder website.
CMS surprises industry by releasing federal upper limit drug pricing files that include weighted average manufacturer prices, without first releasing a rule on the AMP calculation.