As she concluded her term, NCPA President Holly Whitcomb Henry, RPh, delivered a stirring address Oct. 18 urging NCPA convention-goers to make every effort to keep their pharmacies in independent hands as they plan an exit strategy. She also urged the Federal Trade Commission to investigate CVS Caremark in light of patient and pharmacist complaints of higher prices, questionable marketing practices, privacy and other concerns. On Thursday, the company disclosed that CVS Caremark is now the subject of an FTC investigation.
Henry, a Seattle, Washington area pharmacy owner, recalled that the last time NCPA held the annual convention in New Orleans, she joined the Executive Team as Fifth Vice President. Her remarks focused on pharmacy ownership, with the release of the 2009 Digest, sponsored by Cardinal Health. Here are some excerpts:
“Ever since I started pharmacy school in 1973, I’ve been told that independent community pharmacies were dinosaurs, a dying anachronism. I think you might agree with me that the Digest paints quite a different picture of our industry. I’d like to thank Cardinal for helping NCPA by sponsoring our Digest, a valuable benchmarking tool for our members.
“NCPA needs to get the word out to our members, the pharmacy owners. You have valuable, saleable businesses. There are pharmacists who want to buy your pharmacy.
But you must begin to plan your exit strategy. You can’t wait until you are 80, or until some health crisis forces your hand.
“A pharmacy owner from Wyoming told me last month that he had tried for 6 years to sell his pharmacy, but now he has three viable purchasers – all independent – competing for the business. Because he began planning an exit early, he will have the choice of doing what is right for him and his family, and right for his community.
“Don’t accept the offer of the first chain that just happens to send you a letter the same day the latest egregious contract from a PBM lands on your desk. NCPA has lots of resources to help you value your business and structure a sale, including innovative junior partnerships and Employee Stock Option Plans (or ESOPs). Most of the wholesalers and many of the buying groups have resources and networks to help.”
“Fair competition is healthy. Competition inspires us to innovate; to be more efficient; to improve our customer service. But when competition comes from huge oligopolies that ‘manage’ the pharmacy benefit so that beneficiaries are driven into the pharmacies owned by these same giant corporations, that competition is simply unfair. This is why our fight against the unfair business practices of the giant PBMs is so important.
“When the largest PBM, Caremark, was allowed to merge with the largest pharmacy retail chain, CVS, it gave them the opportunity to abuse their power to the detriment of our patients. Thanks to many of you, we were able to collect many examples of their unfair and anticompetitive practices.
“With those stories, we were able to get the attention of the Federal Trade Commission. On May 13, 2009 we were granted an unprecedented hearing with FTC Chairman, Jon Liebowitz, and a number of his top staff. At that hearing, a number of pharmacists told stories of how CVS/Caremark’s anti-competitive practices had harmed their patients and their businesses.
“A very poignant story was told by a courageous couple, Jan and Max Hauser, seniors and beneficiaries of a Medicare Part D Plan. They were longtime patients of Pike’s Pharmacy in North Carolina, and Jesse Pike, Jr. is their pharmacist. After the CVS/Caremark merger, they received a letter informing them that they could no longer get their prescriptions filled at Pike’s Pharmacy, but had a choice – either CVS or Caremark mail order.
“Heaven knows how they did it, but after great perseverance, they were able to obtain their explanations of benefits. Imagine their surprise when they determined that the 30-day supply of simvastatin obtained at Pike’s for $4.70 was billed to their Part D plan by CVS at a rate of $180.99 for a 90-day supply.
“Stories like these, and many others that you’ve sent to us, will shine a light on the practices of the PBMs. We are urging the FTC to open an investigation into the CVS/Caremark merger.
“We are asking you to keep the pressure on. Keep sending your stories and evidence of their egregious, anti-competitive behavior. Keep up the good work of urging your Senators and Congressmen to write to the FTC and ask them to reopen the CVS/Caremark merger.”
“I want to thank each of you for the great privilege of representing you, the pharmacists of Main Street, not Wall Street. You, who go to work each day and make a difference in the lives of the clients and the patients you serve.
“You are the ones who have dug deep in your pockets to support NCPA’s PAC and Legislative Defense Fund. You are the ones who have called your Congressmen and Senators.
“You are the ones who have hosted them in your pharmacies. You are the ones who have performed an MTM session, or picked up the phone to let the doctor know that one of your mutual patients might have a drug-related problem.
“You’ve opened up your pharmacies at night, on weekends and holidays. You’ve delivered in bad weather.
“I salute you for your ownership!”