Magazine article Drug Topics

Pharmacists Livid and Desperate over AMP Rule

Magazine article Drug Topics

Pharmacists Livid and Desperate over AMP Rule

Article excerpt

The clock is ticking. In less than five months, the Centers for Medicare & Medicaid Services will implement its average manufacturer price (AMP) reimbursement rule for Medicaid generic drugs. The rule establishes reimbursement for multisource drugs in the Medicaid program at 250% of the AMP.

It is how CMS interpreted key issues such as what constitutes retail pharmacy and which data should be included in its calculations that has upset pharmacy organizations. The Coalition for Community Pharmacy Action, formed by the National Community Pharmacists Association and the National Association of Chain Drug Stores, termed the rule "devastating," while the American Pharmacists Association stated it was "deeply concerned" about the rule's impact on pharmacists and patients.

As pharmacy organizations lobby Congress to change the rule, pharmacists around the country are beginning to react to its potential impact.

According to Shelley Bailey, R.Ph., of Central Drug in Portland, Ore., Medicaid makes up 75% to 80% of the 100-year-old pharmacy's business. Bailey noted that Central Drug has identified higher cost generice that will be below its acquisition costs. "We'll have to work with physicians to ask that brand drugs be written/' she explained. "We may have to refuse certain medications that cannot be changed." In many cases, she said, it may mean changing the drug to a different class that does not have a generic equivalent.

Other pharmacists, however, are only beginning to learn about AMP's potential impact. Tony Beraldi, R.Ph., of Oard Ross Drug Store in Council Bluffs, Iowa, who is president of the Southwest Iowa Pharmacists Association, said it has been difficult to get R. …

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