Letters to the Editor Published on December 11, 2025.
In southeastern Pennsylvania, nursing homes and long-term care (LTC) pharmacies represent a complex yet vital system designed to ensure the safety and well-being of older residents. These pharmacies serve as an integral component of patient care, providing essential medication management for the elderly population. However, this system now faces a precarious future as a regulatory shift looms on January 1, threatening the operational viability of LTC pharmacies across the region.
The concern stems from the Inflation Reduction Act, enacted during the Biden administration, which permits the federal government to negotiate “maximum fair prices” for select high-cost brand-name medications available under Medicare Part D. This initiative aims to make essential medications more affordable for seniors. However, the implementation of this policy risks causing severe financial strain on LTC pharmacies, potentially leading to their collapse.
The act’s introduction of capped prices on certain medications significantly diminishes the reimbursement rates that LTC pharmacies receive. This change could ripple throughout the healthcare system, negatively impacting the lives of approximately 200,000 Medicare Part D beneficiaries over the age of 65 who rely on long-term care services. The potential fallout could compromise the quality of care and access to medications for a vulnerable elderly demographic.
To mitigate this impending crisis, the current administration has the option to issue an executive order. This order could delay or amend the new drug pricing policy until a more sustainable reimbursement model is developed. Concurrently, bipartisan support in Congress is essential to advance the Preserving Patient Access to Long-Term Care Pharmacies Act (HR 5031). This proposed legislation seeks to implement a temporary supply fee for each prescription filled under the negotiated pricing framework. Such an investment would serve as a lifeline for LTC pharmacies, allowing them to continue their operations through 2027.
The urgency of the situation calls for immediate attention from both the executive branch and Congress. It is essential to prioritize the needs of seniors and ensure that the infrastructure supporting their healthcare remains intact. Well-intentioned policy must not lead to a collapse that would leave countless elderly individuals without the necessary resources for their health and well-being. Ensuring the sustainability of LTC pharmacies is vital for protecting the lives of those who depend on these crucial services.
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