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Independent Pharmacists Initiate Grassroots Action on DIRs

by Michael Rule, Associate Director, Public Affairs and Grassroots | Jul 13, 2017

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When it comes to advocacy, NCPA can't match the financial resources of the PBMs. According to Open Secrets, a website that tracks political and lobbying expenditures, last year CVS Health, the parent company of Caremark, spent $6,018,247 on lobbying, Express Scripts spent $2,703,000, and the Pharmaceutical Care Management Association (PCMA), the trade association for PBMs, spent $2,728,160—a total of $11,449,407. NCPA, by comparison, spent $1.38 million.

However, NCPA is able to more than hold our own in the legislative trenches because of the grassroots activism of thousands of independent pharmacists across the country and the millions of patients they serve. NCPA members routinely contact the offices of their legislators to voice their opinions on various legislative priorities, host legislators for pharmacy visits, or meet with their legislators while in district. Some members who undertake their own grassroots initiatives to help advance legislative priorities serve as a model for other pharmacists. Here are two worthy of recognition.

First, in Illinois, NCPA member Curtis Sherman, President of Sherman's Pharmacy in Brimfield, engaged his patients to sign a petition letter urging support for legislation to ban retroactive pharmacy direct and indirect remuneration (DIR) fees (S. 413/H.R. 1038, the Improving Transparency and Accuracy in Medicare Part D Drug Spending Act). Sherman's Pharmacy serves eight small communities, and in the end nearly 600 patients signed the petition voicing their desire for Congress to pass this legislation to ensure their independent pharmacy remains viable now and in the future. The petition also urged legislators to ensure the legislation addresses all such fees. NCPA staff delivered the petitions to the offices of Sens. Dick Durbin (D-Ill.) and Tammy Duckworth (D-Ill.) and Rep. Darin LaHood (R-Ill.).

Similarly, in Delaware, Greenhill Pharmacy in Wilmington assigned an employee to collect signatures from independent pharmacy owners in the state to voice support for the DIR bills prior to attending NCPA's 2017 Congressional Pharmacy Fly-In. During legislative visits, this joint letter was shared with the offices of Delaware's two senators, Tom Carper and Chris Coons, and Rep. Lisa Blunt-Rochester, the state's at-large member of Congress. The letter demonstrated widespread support for this important legislation from independent pharmacists across the state. Rep. Blunt-Rochester has since signed on as a cosponsor of H.R. 1038.

These are just two examples of independent pharmacists taking it upon themselves to organize their own grassroots action to advance legislation important to community pharmacy, which has already yielded some positive results. Such grassroots activity helps neutralize the financial advantage of the PBMs, and we encourage other independent pharmacists to follow these examples. NCPA has grassroots resources available on our website, or you can contact Michael Rule at for ideas and assistance. Remember, your voice makes a difference.