The comments cite a study, commissioned by the industry group, that found "wasteful spending" to nursing home residents covered by Medicare Part D amounts to only 2.9 percent of total dispensed value. Increasing the dispensing frequency would cut waste by $125 million, the study says, but would raise dispensing fees paid to the pharmacies for their services by $900 million — a net loss to the Medicare program and to taxpayers.
The study estimates that Medicare would only save money if drugs costing $400 or more are dispensed more frequently. Cheaper drugs aren't worth it, the study says, and an LTCPA official tells The Hill that the group is particularly concerned that federal regulators' "transitional approach" is leaving the door open to more frequent dispensing of low-cost generic drugs down the line.
In their proposed rule, regulators write that the regulation only targets brand-name drugs but that "nothing precludes LTC pharmacies and facilities from expanding 7-day-or-less dispensing to more than brand-name drugs, and we encourage Part D sponsors to facilitate that practice."
The LTCPA official said the group wants more flexibility, pointing out, for example, that high-cost drugs and those more likely to cause negative reactions among patients are already dispensed more frequently.
"While LTCPA supports the goal of reducing waste," LTCPA Executive Director Bill Daniel said in a statement, "we also recognize the need to consider all costs associated with the proposed rule, so that unintended consequences do not result from the application of the rule. Given that it's the American taxpayer ultimately shouldering the burden of paying for this statute, it is critical that calculations such as those provided in our study be factored into the drafting of regulations."