Magazine article Drug Topics

Breakthrough Decision

Magazine article Drug Topics

Breakthrough Decision

Article excerpt

FTC sanctions

R.Ph. networks

for negotiating

prices with payers

Pharmacists can form networks for the purpose of offering educational and other services to patients without violating antitrust law, if they put themselves at financial risk in rendering the service.

That is the essence of a breakthrough advisory opinion issued by the Federal Trade Commission (FTC) in response to a request by the New Jersey Pharmacists Association (NJPhA). The opinion opens the way for community R.Ph.s to join together and negotiate collectively with insurers, pharmacy benefit managers, and managed care companies for providing such services.

"For the first time, a regulatory agency of the federal government has recognized that pharmacists are capable of providing services and can collectively negotiate for those services as long as there is an element of risk," said Allen Nichol, Pharm.D., who requested the opinion last November when he was CEO of the New Jersey Pharmacists Association.

Nichol said the opinion gives pharmacists the opportunity to escape from the bind they have been in with regard to insurance companies. Until now, he noted, they have been unable to get around the FTC's antitrust guidelines that have protected insurance companies and made it impossible to bargain with them.

"To me, that is monumental," said Nichol. "It says that we will get together and negotiate what we believe is fair and equitable compensation."

At the same time, it is important to recognize what the opinion does not do, cautioned David Schulke, director of alliance development and regulatory affairs of the American Pharmaceutical Association, which assisted Nichol in his approach to the FTC staff. "It is very important to understand that this is not a green light for people to get together to affect drug prices," he said. "That was a very important issue to the FTC staff. They were very concerned that pharmacists might try to control drug prices by getting together. That might seem laughable to pharmacists, but the FTC took it seriously. This is not about drug products, this is about pharmaceutical care services," he emphasized.

But, like Nichol, Schulke found value in the opinion. FTC "took a look at the literature, which shows that pharmacists can provide valuable services to patients with diabetes and asthma, and [FTC] found that persuasive," he added.

In its opinion, FTC said that its decision recognized that the existence of substantial financial risk sharing by providers may justify treatment under the so-called rule of reason. …

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