Long title | To amend the Public Health Service Act to ensure transparency and proper operation of pharmacy benefit managers |
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Acronyms (colloquial) | H.R. 1971 |
Enacted by | the 112th United States Congress |
Legislative history | |
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The Pharmacy Competition and Consumer Choice Act of 2011 (H.R. 1971) is the legislation that was introduced in the 112th United States Congress on May 24, 2011, with the full title of the bill stating to "amend the Public Health Service Act to ensure transparency and proper operation of pharmacy benefit managers". [1] The chief sponsor of the legislation was Republican Cathy McMorris Rodgers (R-WA5), while other notable co-sponsors include Democrat Anthony Weiner (D-NY9), Republican Austin Scott (R-GA8), Democrat Jesse Jackson, Jr. (D-IL2) and Republican Tom Marino (R-PA10). [2]
Support for the bill came from the National Community Pharmacists Association (NCPA). In a press release dated on May 24, 2011, NCPA writes that the bill would protect patients' ability to go to the pharmacy of their choice, eliminate needless pharmaceutical spending and allow legitimate anti-fraud oversight, while avoiding abusive pharmacy audits. [3]
Opposition to the bill came from the Pharmaceutical Care Management Association (PCMA), with arguing that in efforts to carve drugstores out of the national fight against health care fraud, independent drugstores are demanding new laws to limit the use of audits and other tools used to detect pharmacy fraud. [4] They state that with 93% of community pharmacy revenue being derived from prescriptions versus the front-end, those pharmacists also share a greater sensitivity to any changes in prescription drug reimbursement, and consequently any changes in federal or state programs would disproportionately affect these small-business owners. [5]
On April 24, 2012, Americans for Tax Reform and the Cost of Government Center sent a letter to the legislation's chief sponsor, Cathy McMorris Rodgers, arguing that H.R. 1971 takes the wrong approach to pharmaceutical industry oversight reform while preventing pharmaceutical benefit managers from investigating and stopping prescription drug fraud as well as medicare fraud, waste and abuse. [6] However, McMorris Rodgers responded that the bill would increase competition and promote transparency, and it would make the delivery of pharmacy services much more efficient. [7]
Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a requirement for a prescription from a healthcare professional, as opposed to prescription drugs, which may be supplied only to consumers possessing a valid prescription. In many countries, OTC drugs are selected by a regulatory agency to ensure that they contain ingredients that are safe and effective when used without a physician's care. OTC drugs are usually regulated according to their active pharmaceutical ingredient (API) rather than final products. By regulating APIs instead of specific drug formulations, governments allow manufacturers the freedom to formulate ingredients, or combinations of ingredients, into proprietary mixtures.
Shoppers Drug Mart Corporation is a Canadian retail pharmacy chain based in Toronto, Ontario. It has more than 1,300 stores operating under the name Shoppers Drug Mart in nine provinces and two territories, and as Pharmaprix in Quebec.
Pharmacy is the clinical health science that links medical science with chemistry and it is charged with the discovery, production, disposal, safe and effective use, and control of medications and drugs. The practice of pharmacy requires excellent knowledge of drugs, their mechanism of action, side effects, interactions, mobility and toxicity. At the same time, it requires knowledge of treatment and understanding of the pathological process. Some specialties of pharmacists, such as that of clinical pharmacists, require other skills, e.g. knowledge about the acquisition and evaluation of physical and laboratory data.
A prescription drug is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The reason for this difference in substance control is the potential scope of misuse, from drug abuse to practicing medicine without a license and without sufficient education. Different jurisdictions have different definitions of what constitutes a prescription drug.
The Medicare Prescription Drug, Improvement, and Modernization Act, also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.
Wilbert Joseph Tauzin II is an American lobbyist and politician. He was President and CEO of PhRMA, a pharmaceutical company lobby group. Tauzin was also a member of the United States House of Representatives from 1980 to 2005, representing Louisiana's 3rd congressional district.
The Pharmaceutical Benefits Scheme (PBS) is a program of the Australian Government that subsidises prescription medication for Australian citizens and permanent residents, as well as international visitors covered by a reciprocal health care agreement. The PBS is separate to the Medicare Benefits Schedule, a list of health care services that can be claimed under Medicare, Australia's universal health care insurance scheme.
Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs through prescription drug insurance premiums. Part D was originally proposed by President Bill Clinton in 1999, then by both political parties and Houses of Congress and President Bush during 2002 and 2003. The final bill was enacted as part of the Medicare Modernization Act of 2003 and went into effect on January 1, 2006. The various proposals were substantially alike in that Part D was optional, it was separated from the other three Parts of Medicare in most proposals, and it used private pharmacy benefit managers on a regional basis to negotiate drug prices. The differences included consistent benefits nationwide in the Clinton/Democratic proposals and a wide array of deductibles and co-pays ; Bush's initial proposal included true catastrophic coverage for middle income seniors, but it was not in the final version and is a feature still not available in Part D.
An independent pharmacy is a retail pharmacy that is not directly affiliated with any chain of pharmacies and is not owned by a publicly traded company. Independent pharmacies are pharmacist-owned, privately held businesses in varying practice settings. They include single-store operations, pharmacist-owned multiple store locations, franchise, compounding, long-term care (LTC), specialty, and supermarket pharmacy operation. Independent pharmacy owners generally have more flexibility to build personalized customer relationships and they strive to differentiate their services from big-chain corporations.
An online pharmacy, internet pharmacy, or mail-order pharmacy is a pharmacy that operates over the Internet and sends orders to customers through mail, shipping companies, or online pharmacy web portal.
In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. According to the American Pharmacists Association, "PBMs are primarily responsible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims." PBMs operate inside of integrated healthcare systems, as part of retail pharmacies, and as part of insurance companies.
CVS Health is an American healthcare company that owns CVS Pharmacy, a retail pharmacy chain, CVS Caremark, a pharmacy benefits manager, Aetna, a health insurance provider, among many other brands. The company's headquarter is in Woonsocket, Rhode Island.
A pharmacy is a retail shop which provides prescription drugs, among other products. At the pharmacy, a pharmacist oversees the fulfillment of medical prescriptions and is available to give advice on their offerings of over-the-counter drugs. A typical pharmacy would be in the commercial area of a community.
China Nepstar Chain Drugstore Ltd., which conducts business as China Nepstar, is China's largest retail drugstore chain, based on the number of directly operated stores.
The history of pharmacy in the United States is the story of a melting pot of new pharmaceutical ideas and innovations drawn from advancements that Europeans shared, Native American medicine and newly discovered medicinal plants in the New World. American pharmacy grew from this fertile mixture, and has impacted U.S. history, and the global course of pharmacy.
Preserving Our Hometown Independent Pharmacies Act of 2011 is legislation that was introduced in the 112th United States Congress on May 23, 2011, with the full title of the bill stating to "ensure and foster continued safety and quality of care and a competitive marketplace by exempting independent pharmacies from the antitrust laws in their negotiations with health plans and health insurance insurers". The chief sponsor of the legislation was Republican Tom Marino (R-PA10), while other notable co-sponsors include Republican Cathy McMorris Rodgers (R-WA5), Democrat Leonard Boswell (D-IA3), and Republican Austin Scott (R-GA8).
Preferred pharmacy network is a group of pharmacies that involves a prescription drug plan that selects a group of preferred pharmacies, which likely include pharmacies willing to give the plans a larger discount than other pharmacies. Consumers are then able to choose between preferred or non-preferred pharmacies. Those who choose the preferred pharmacies then save money in the form of lower copayment.
Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. Telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing. Remote dispensing of medications by automated packaging and labeling systems can also be thought of as an instance of telepharmacy. Telepharmacy services can be delivered at retail pharmacy sites or through hospitals, nursing homes, or other medical care facilities.
The Association for Accessible Medicines (AAM), Washington, D.C., is a trade association representing the manufacturers and distributors of generic prescription drugs, manufacturers and distributors of bulk pharmaceutical chemicals, and suppliers of other goods and services to the U.S. generic drug industry. As the primary lobby for makers of generic drugs, AAM's stated mission is to advocate for public policies that facilitate timely access to lower-cost, FDA-approved generic and biosimilar medicines by consumers and patients. Over the 10-year period 2008 through 2018, the use of generic drugs generated $2 trillion in U.S. healthcare savings.
Drug disposal is the discarding of drugs. Individuals commonly dispose of unused drugs that remain after the end of medical treatment. Health care organizations dispose of drugs on a larger scale for a range of reasons, including having leftover drugs after treating patients and discarding of expired drugs. Failure to properly dispose of drugs creates opportunities for others to take them inappropriately. Inappropriate disposal of drugs can also cause drug pollution.