The nation’s independent community pharmacies dispense about 40 percent of all retail prescriptions. These small businesses employ 315,000 people, including some 63,000 pharmacists. As community pillars, they contribute greatly to their local economy and tax base. They also dispense a greater percentage of cost-saving generic drugs than some other pharmacy providers, like mail order.
Independent pharmacies are often in underserved areas, particularly rural and urban ones, and provide specialty health items hard to find elsewhere. You can see one in action just a few blocks from the U.S. Capitol in Grubb’s CARE Pharmacy. No appointment necessary.
In Gallup’s annual Honesty and Ethics poll, pharmacists perennially rank near the top in public confidence. In addition, independent pharmacies were singled out by patients for high customer satisfaction in surveys conducted by Consumer Reports and J.D. Power & Associates.
It is that nexus of patient accessibility and trust that makes community pharmacists a natural resource to help tackle some of the biggest health care challenges.
First, we must maximize the therapeutic benefits of prescription medications to improve health outcomes and lower costs. The incorrect use of legitimately prescribed medications is estimated to cost our health care system as much as $290 billion annually, according to NEHI. Regular, formalized patient-pharmacist counseling, known as “medication therapy management,” or MTM, has been shown to produce as much as a 12-to-1 return on investment. H.R. 891/S. 274, the Medication Therapy Management Benefits Act, would give more Medicare patients access to cost-saving medication reviews and face-to-face consultations with licensed pharmacists.
Second, the fight against diabetes is one in which community pharmacists are playing an enhanced role. Increasingly, pharmacists are providing diabetes education and training to help patients manage their condition more effectively and avoid costly complications. By supporting The Medicare Access to Diabetes Supplies Act, sponsored by Reps. Aaron Schock (R-Ill.) and Peter Welch (D-Vt.), Congress can protect Medicare beneficiaries’ access to diabetes testing supplies and one-on-one counseling on their proper use at local pharmacies.
Of course, for these efforts to fully succeed, patients must have access to their pharmacy of choice in the first place. That’s why we encourage Congress to support legislation to protect patient choice, preserve community pharmacies and enhance competition among pharmacy providers by doing the following:
• Ban health insurance plans or their intermediaries, such as pharmacy benefit managers (PBMs), from requiring patients to use a pharmacy owned by the plan/PBM or financially penalizing the use of rival pharmacies. It’s a conflict-of-interest as obvious as the proverbial fox guarding the henhouse and one that can lead to self-dealing, anticompetitive behavior. In fact, in recent years, the largest pharmacy benefit managers paid out $370 million to settle claims of fraud and deceptive conduct.
• Allow legitimate waste, fraud and abuse oversight by insurance companies, but prohibit bounty-hunting, commission-based auditors from lining their pockets by overturning legitimate prescriptions and recouping large sums on minor technicalities.
• Support H.R. 1839 to let independent community pharmacies collectively negotiate the terms and conditions of insurance contracts with billion-dollar corporations. Doing so would help produce plan designs that better protect patient choice and are fairer to small pharmacies.
Community pharmacists are honored to have strong, bipartisan support for these and other issues. To that end, Reps. Cathy McMorris Rodgers (R-Wash.) and Anthony Weiner (D-N.Y.) have just re-established the Congressional Community Pharmacy Caucus in the 112th Congress. Sen. Jerry Moran (R-Kan.) is spearheading the launch of the first such caucus in the other body. We greatly appreciate their efforts. Hopefully, both groups will serve as forums for discussion and action on policies to protect patients’ access to their pharmacy of choice and to better utilize pharmacists in our health care system.
In these and in other ways, the nation’s independent community pharmacists stand ready to work with Congress to help improve health outcomes and reduce overall costs.
B. Douglas Hoey, RPh, MBA is the executive vice president and CEO of the National Community Pharmacists Association.