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PROPOSED RULE COULD LOWER GENERIC DRUG SALES, PHARMACY GROUP CONTENDS

February 28, 2007

A new Medicaid rule being proposed by the Centers for Medicare & Medicaid Services (CMS) could lower generic drug sales and should be amended to reflect actual acquisition costs for retailers that fill prescriptions with generic drugs, a pharmacist group said.

The rule, proposed last December, calls for an $8.4 billion cut to the Medicaid program over the next five years. The majority, roughly 90 percent, of those reductions would come from the drug reimbursements that pharmacies collect to dispense generic prescription drugs, the National Community Pharmacists Association (NCPA) said.

NCPA Senior Vice President of Communications Robert Appel said that the proposed regulation "creates a tremendous disincentive for generic drug utilization" and that pharmacies faced with drug reimbursement rates lower than their acquisition costs would likely fill drug prescriptions with brand drugs if that led to a potential to generate higher sales income.

Under the rule, pharmacies participating in the Medicaid program would receive a generic drug reimbursement rate 36 percent lower than their acquisition costs, Appel said, referring to a Government Accountability Office study on the proposed rule.

The CMS proposed the rule to implement certain provisions of the Deficit Reduction Act of 2005 that pertain to prescription drug payments under Medicaid. The rule is set to go into effect July 1.

A copy of the proposed rule is available online at www.cms.hhs.gov/quarterlyproviderupdates/downloads/cms2238p.pdf ( http://www.cms.hhs.gov/quarterlyproviderupdates/downloads/cms2238p.pdf ).

( http://www.fdanews.com/did/6_38/ )