What's good for pharmacy is good for health care - Opinion - Brief Article - Editorial

The real problem with keeping the fox out of the henhouse is that the fox usually gets hungry again.

My congratulations go. to everyone in the chain drug store industry and our allies in community pharmacy who worked so hard to "educate" Congress on the risks of giving PBMs a central role in a Medicare prescription drug p1 an.

With the defeat of four such plans in the U.S. Senate late last month, the industry deserves great credit for broadcasting our message that putting PBMs in charge is not unlike putting the fox in a henhouse.

Unfortunately, the battle isn't over yet, and the fact we had to fight so hard is indicative of a larger problem. Unless we do more to promote the value of community pharmacy, we could be fighting foxes for a long time to come.

The Medicare battle is just one of many in which retail pharmacy is vulnerable. As prescription drug use soars, prices rise and budget troubles continue, we can expect further price pressure on the retail sector.

Already, many state governments are cutting Medicaid reimbursements to pharmacies, and third party payers are looking for ways to rein in prescription drug spending.

Indeed, the PBMs are more a symptom of the problem than the cause, and efforts to control prices could become more aggressive yet. Our challenge is to better demonstrate the value of community pharmacy--in terms of health benefits, cost savings, patient choice and convenience.

Fortunately, the facts are on our side. Survey after survey demonstrates that patients value the personal attention and care of local pharmacists and are resistant to efforts that would force them to use mail-order pharmacies.

Other research shows that various "discount" schemes--including those devised by the PBMs--offer customers no greater savings than those provided by retail pharmacies--and without the benefit of pharmacy services provided by community drug stores.

One problem is a basic misunderstanding of prescription drug pricing. Even those who should know better--the legislators and regulators who make public policy--often don't understand the constraints on retail pharmacies which, after all, have little control over the cost of prescription drugs.

Retail pharmacies earn, on average, a mere 2 percent profit on every prescription they dispense, a margin that leaves little room for further cuts. Worse yet, both those who make policy and those who set reimbursement rates rarely factor in the added value that community pharmacists bring to the health care delivery system. No one expects physicians to offer health care advice an d counseling without charging for it, but that is precisely what pharmacists do every day.

We cannot effectively serve the Medicaid population--those with the least access to e services and those who rely most on medication therapy--if the federal government pursues policies that devalue and diminish the role of retail pharmacists.

And we cannot effectively serve as a health care resource in our communities if our pharmacy operations are so constrained by cost battles that we can no 1onger recruit the pharmacists we need nor allow them the time necessary to provide customer care and counseling.

We need to work together to make that case. We need to demonstrate that policies that are good for pharmacy are good for the nation's health care system. And if we are successful, in the future we won't have to work so hard to protect our interests because we will have demonstrated that community pharmacy serves the best interests of all.

Mark Griffin is the president and chief executive officer of Lewis Drug and chairman of the National Association of Chain Drug Stores.

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