Next 100 Days: Pharmacy Wary

Article excerpt

With its hectic first 100 days behind it and renewed by an extended spring break, the 104th Congress now has a chance to examine a number of pharmacy-related issues. Topping the list are retail pharmacy's hard-won successes in enactment of state any-willing-provider laws. They would be erased nationwide by health insurance reform legislation forging ahead in the House of Representatives.

Congressional committees also are expected to look at weakening a new law on physician self-referrals, which covers outpatient prescription drugs; reining in what they consider regulatory excesses by the Food & Drug Administration, including pharmacist compounding; and perhaps an airing of how the managed care industry operates.

Furthest along in the legislative process is a health insurance reform plan whose chief sponsor is Rep. Harris W. Fawell (R, Ill.), chairman of the Economic & Educational Opportunities Committee's subcommittee on employer-employee relations. Fawell held several days of hearings on his H.R. 995, and, although he is redrafting it, the basic premise remains the same: Amend the 1974 Employee Retirement Income Security Act (ERISA) to make it easier and more affordable for small businesses to offer health insurance to their employees. State laws that prevent small businesses from forming health purchasing cooperatives would be overridden and so would those that mandate health benefits.

Of most importance to pharmacy is a section entitled "preemption of state antimanaged care laws," including those that restrict the ability of insurers to limit the number of participating providers. "Those attempting to 'manage' our market seek to reduce the number of viable competitors and steer unwilling consumers to a few select competitors often owned by pharmaceutical manufacturers or insurance companies," charged John Rector, NARD senior v.p. for government affairs, in testimony submitted to Fawell's subcommittee. He noted that six states represented by subcommittee members were among the 30 that have enacted pharmacy any-willing-provider laws since 1987.

"A predictable but select group of interests, however," Rector continued, "oppose this procompetitive, proconsumer legislation, including mail-order pharmacies, hospitals, HMOs, and others receiving discriminatory prices from drug manufacturers. Such interests prefer exclusive, anticompetitive agreements to open competition. …