As published in Drug Topics
When President Obama was facing challenges in negotiations over raising the debt ceiling, he spoke to the nation, urging the American people to make their voices heard and contact their members of Congress to pressure them to come to what he called a balanced solution.
The next day, many Americans heeded this call to action; it was reported that website traffic had crashed several members' websites and that the capitol switchboard was handling more than 35,000 calls per hour, almost double the average rate.
After a compromise was reached, the President thanked Americans, saying that it was their phone calls and e-mails that made such a deal possible.
When people express their opinions and hold their elected officials accountable, we see the essence of democracy.
Making our voices heard
As independent community pharmacists, we are both healthcare providers and small-business owners, and we face several challenges that impact both these important roles. In order to effect positive solutions to these challenges, we too must make our voices heard.
As small-business owners, we are squeezed by the pharmacy benefit managers (PBMs), who reimburse us at rates that are often lower than our acquisition costs. They also seek to further swell their coffers through burdensome audits that often penalize us for minor bookkeeping errors, when to search for intentional fraudulent practices would be more to the point.
This squeeze may be further exacerbated by the recently proposed merger of PBM giants Express Scripts and Medco, which would create a behemoth in the PBM industry, to the detriment of patients and pharmacists.
In our role as healthcare providers, we spend many hours preventing errors and serving the patients who rely on our counsel and expertise. They depend on us to help them use their medications correctly and adhere to their prescription regimens properly. Many of us have heard from patients who received the wrong prescription by mail order or did not receive their mail-order medications on time, and who called upon us because we were the only healthcare professional they could turn to for assistance.
Some independent pharmacists have simply accepted these PBM-generated challenges as a fact of doing business, one that is often derided as also commoditizing the profession of pharmacy. Others have been forced to close their stores because they could not withstand these PBM practices.
This problem can be remedied if enough of us take the action necessary to bring about change. We need to make our voices heard, and we need to support legislation that has been introduced in Congress that helps to level the playing field.
The Pharmacy Competition and Consumer Choice Act, H.R. 1971/S. 1058, addresses many PBM abuses. It prohibits practices such as extrapolation and it forces PBMs to focus audits on identifying acts of intentional fraud, which is where they should be focused, rather than on penalizing pharmacies for typographical or bookkeeping errors.
In addition, H.R. 1946, the "Preserving Our Hometown Independent Pharmacies Act," would allow independent pharmacies to join together to negotiate contracts with PBMs in the way retail chains negotiate now. To be sure, the PBMs would still have the upper hand, but at least independent pharmacies would have a stronger voice during negotiations.
We all need to contact our members of Congress and urge them to support this legislation.
We also need to express our opposition to further concentration among PBMs by demanding that our members of Congress urge the FTC to block the ESI-Medco merger.
While these legislative solutions may not address all our challenges, they are important steps forward. As pharmacists, we must take it upon ourselves to educate health-plan sponsors and our elected officials about our unique role in healthcare. And we must impress upon them the necessity of their support for solutions to the challenges facing our industry. One way for you to do this is to visit http://www.ncpa-actioncenter.com and send an e-mail to your members of Congress.
After all, if we do not tell our story, who will?
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