Tell Congress to Protect Patient Access to Long-Term Care

Recent Medicare Part D policy changes and a broken PBM-driven payment model threaten the future of LTC pharmacies. In January 2026, brand prices for 10 major brand drugs will alter how LTC pharmacies are paid for their services. LTC residents rely heavily on 8 of the first 10 drugs subject to Medicare-negotiated prices. This means that many LTC pharmacies will face unsustainable financial losses from dispensing these medications.

We need your help to advocate for legislative action that allows LTC pharmacies to continue providing medicines and essential pharmacy services to our nation’s most vulnerable patient population. Please send a message to your Congressional offices about the need to visit an LTC pharmacy and seek an LTC pharmacy fix before drug price negotiation goes live in 2026!

Dear [Lawmaker],

I am writing as a long-term care pharmacist and constituent to notify your office of a key policy issue that we need immediately addressed in the early part of the 119th session.

Long-term care (LTC) pharmacies are the backbone of pharmacy services for seniors and frail adults as they provide all the medication needs for nursing homes and many assisted living facilities. Our pharmacy relies fully on prescriptions to keep our operations going as LTC pharmacies have for over 5 decades. Unfortunately, the way LTC pharmacies have received payment from Medicare Part D depends in large part on how pharmacy benefit managers (PBMs) pay us. Although 90% or more of our prescriptions are generic, due to our PBM contracts, we often lose money on generics and survive on brand name dispensing.

With the passage of the Inflation Reduction Act (IRA), there is an issue we need fixed before implementation of IRA’s new drug pricing negotiation program goes live in 2026. Eight of the ten drugs named in the initial drug price negotiations for 2026 are heavily used by nursing home and assisted living facility patients, therefore they are significant to LTC pharmacies. Since the newly established maximum fair price (MFP) from IRA’s drug price negotiation program has to be carried down the system from the drugmaker to the beneficiary, analysis projects that any additional fees or rebates will be nonexistent and likely cause a negative payment for pharmacies.

While pharmacists like me fully support lower drug prices for our patients, we need to make sure the payment structure going into 2026 can make our pharmacies viable and we are very concerned about immediate impacts! As we work with LTC pharmacy champions to introduce bipartisan legislation to provide relief going into 2026 and make important PBM reforms, we ask that your office 1) reach out to visit our pharmacy and learn more about the complexity of LTC pharmacy and 2) learn more about the issue we are facing by visiting saveseniorrx.org.

Thank you for supporting your local pharmacies!

Sincerely,
______

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