Healthcare groups oppose PPACA's FSA requirement for Rx OTCs

July 25, 2011

CVS Caremark, the National Community Pharmacists Association, and several healthcare groups are supporting a new bill that would allow patients to purchase OTC medications through flexible spending accounts (FSAs) and health savings accounts (HSAs).

CVS Caremark, the National Community Pharmacists Association (NCPA), and several healthcare groups are supporting a new bill that would allow patients to purchase OTC medications through flexible spending accounts (FSAs) and health savings accounts (HSAs).

The “Restoring Access to Medication Act,” introduced in mid-July in both houses of Congress, would restore the ability of patients to purchase OTC drugs through FSAs and HSAs. The Patient Protection and Affordable Care Act had eliminated this practice, requiring that FSA and HSA patients obtain prescriptions for OTC medications.

“A lot of our patients and pharmacists are confused or burdened by this provision. When patients go to file with their FSAs [for common OTC medications], they are turned down. Then, they go back to the pharmacists, who say they need to call their doctors, or they offer to call doctors for the patients,” said David Sanders, director of federal affairs for NCPA.

While the goal of the Patient Protection and Affordable Care Act was to expand access to affordable care, limiting coverage of OTC medicines will increase costs to the healthcare system, according to a recent letter sent to Congressional representatives by NCPA, the National Association of Chain Drug Stores (NACDS), the Food Marketing Institute (FMI), the American Medical Association (AMA), and several other groups.

The groups pointed out that more than 90% of Americans prefer to seek treatment with OTCs before seeing a healthcare provider. “These medicines save consumers billions of dollars annually through reducing unnecessary doctors’ visits, less time lost from work, and the cost advantage of OTC medicines,” the groups wrote.