Just before Angela Cheng-Lai arrived on Capitol Hill for ASHP Legislative Day on Sept. 17, the New York health-system pharmacist oversaw a patient's complex switch from an IV treatment for pulmonary hypertension to an oral medication.
Medications for pulmonary hypertension require careful titration because adjusting them even slightly can cause significant changes in patients’ blood pressure and breathing, Cheng-Lai explained to staff members in Sen. Kirsten Gillibrand’s office.
“To adjust these medications,” she said, “you need an expert.”
Her story illuminating the kind of work health-system pharmacists do every day led Cheng-Lai to one of ASHP’s top priorities: strengthening funding for pharmacy residency programs.
“The reason why I'm able to be the pharmacist that I am today,” she said, “is because I got residency training more than 30 years ago.”
Cheng-Lai and other ASHP members used the annual Capitol Hill event, a signature highlight of ASHP Policy Week, as an opportunity to educate Congress on the critical work of health-system pharmacy and to advocate on key issues, including residency funding, provider status, and protections for the 340B Drug Pricing Program.
“Pharmacists play a very important role that most people don't know about,” Cheng-Lai said.
The day began with remarks from ASHP president Melanie A. Dodd on the importance of members using their experience to make the case for reform. “As representatives of the pharmacy profession, you come to these meetings with expertise that no one else has,” she said. “Whether you are a student, a technician, a first-year member of council, or you're a seasoned pharmacist that's been in the field for many, many years, all of your voices matter.”
Dodd added, “Today is a day about telling those stories and about advocating for your profession and for the people that you care for.”
The keynote speaker at the kick-off breakfast was U.S. Rep. Brad Schneider of Illinois, a co-sponsor of the Ensuring Community Access to Pharmacist Services (ECAPS) Act, ASHP-supported legislation that would provide Medicare coverage for certain testing and treatment services provided by pharmacists.
“We learned a lot about the weaknesses of our health care system from the pandemic, but we also learned how important pharmacies and pharmacists are in the healthcare system,” said Schneider. “How do we get ECAPS passed? It’s what you're doing today. It's going and talking to members of Congress, explaining what you do, how it benefits our community, telling those stories.”
As they fanned out to their meetings, members like Jaclyn Boyle of Ohio were ready to discuss the policy impacts on patients back home. Boyle, associate professor of pharmacy practice at Northeast Ohio Medical University, said ECAPS was critical, particularly as providers try to expand services to more patients.
“If we don't have a sustainable way to do that financially, then all of our services won't be able to keep expanding, to keep growing, and to really take care of more patients in a more longitudinal, comprehensive way,” said Boyle.
And as an educator training the next generation of pharmacists, Boyle said she is concerned about the confusing federal auditing requirements that are hurting pharmacy residency programs.
“To have access to that training is so vitally important. We're helping to prepare them for direct patient care roles after graduation and the rest of their careers,” said Boyle. “It’s imperative that we keep those residency programs where they are and allow places to continue expanding residency access.”
Virginia’s delegation headed to its first stop, Sen. Mark Warner’s office, with warnings about the impacts of potential cuts to residency funding or the 340B program. Brian Spoelhof, manager of pharmacy at UVA Health, told Warner’s staff that drug manufacturers’ recent attempts to undercut 340B will damage hospitals’ abilities to care for the neediest patients.
“The reality is that most all hospitals that participate in the 340B program have margins of one, maybe two percent, and we're constantly looking for sources of revenue to support our underserved patient populations and the rural populations,” Spoelhof said.
Brad McDaniel, medication utilization strategy pharmacist at Carilion Clinic in Roanoke, Virginia, added that the stakes are even higher as health systems face deep Medicaid cuts from recent spending legislation.
“We’re going to be relying more and more on (340B) discounted drug pricing in order to support those facilities and keep them open,” he said.
Delia Allen, a pharmacist at St. Jude Children’s Research Hospital in Tennessee, discussed her perspective caring for children with cancer and other serious conditions. “My main message to congressional staff was centered on the critical importance of access — to both pharmacists and the services we provide,” Allen said after her meetings. “These patients often face complex, life-threatening conditions, and having a pharmacist integrated into their care team directly impacts their outcomes and overall experience.”
She also emphasized the value of the 340B program.
“Like many pediatric institutions, our hospital reinvests the savings from 340B directly into patient care — supporting essential programs and daily operations that wouldn’t be possible otherwise,” said Allen. “If manufacturers are allowed to impose restrictions on this program, it could significantly disrupt the care we provide to vulnerable populations.”
