Preserve community access to diabetes supplies, says pharmacy group

Thursday, May 13, 2010

WASHINGTON - Backers of a bill that would remove certain diabetes testing supplies from national competitive bidding say it will inject "some sanity" into the program.

Introduced May 6 by Reps. Peter Welch, D-Vt., and Mike Rogers, R-Mich., the Medicare Access to Diabetes Supplies Act would exempt diabetes supplies like strips, monitors and lancets, that are furnished by small community pharmacies, from the bidding program. The Small Business Administration classifies small pharmacies as those with annual sales of $7 million or less.

While nearly three quarters of community pharmacists offer some DME, including diabetes supplies, it typically comprises less than 10% of their business, says John Norton, associate director of public relations for the National Community Pharmacists Association (NCPA).

"To have us go through such an arduous process to sell something that is such a small part of our business but that is something our patients truly appreciate?" said Norton. "It's flawed thinking."

Furthermore, small pharmacies can't compete on price against companies that focus on diabetes, nor do they have the ability to service an entire metropolitan statistical area, as required under the program, said Norton.

"You'll have a lot of patients lose access because their pharmacies couldn't win the bid," he said.

Currently, only diabetes supplies furnished by mail order are included in competitive bidding but that is likely to change, said John Coster, senior vice president of government affairs for NCPA, during a conference call last week.

"CMS is in the process of developing rules for the next round of competitive bidding, which are supposed to go into effect in 2013," he said. "They have made pretty regular and consistent statements that at some point they would like to include diabetes supplies."

That could include all mail order and retail, or CMS could consider having retail (suppliers) bid against other retail suppliers or retail (suppliers) bidding against mail order, he said.

At the end of the day, including the category in competitive bidding or moving it all to mail order is "penny-wise and pound-foolish," said Coster.

"The evidence suggests that mail order is simply not going to be able to provide the quality of care that the community pharmacy can," he said. "CMS (would try) to save a few pennies. You are going to save more money in the long term when you have the pharmacy in the community help manage the patient's diabetes."