‘Get into Politics or Get Out of Pharmacy’

By Bruce T. Roberts, RPh

That’s the unofficial motto of NCPA’s advocacy efforts. A key component to that work is our political action committee (PAC), which was featured in USA TODAY this week. The paper reports that in 2009 our PAC donated three times the amount it did to community pharmacy supporters in 2007, the last non-election year. What’s behind the trend and why should political advocacy be a priority for every community pharmacist?

About five years ago, I challenged community pharmacists to step up to the plate. Many did. Our grassroots efforts are more robust. The NCPA PAC has risen from 963rd to the 40th largest association PAC in the country.  $1 million in contributions was distributed last year to candidates who support policies to help community pharmacists help patients.

Two events created the perfect storm for community pharmacists to realize how much impact the government has on our business. 

  • In 2006, Medicare Part D implementation was an eye-opener. Very slow reimbursement from plans and other problems led to the closure of thousands of independent community pharmacies in the first year or so of implementation. (A Medicare Part D prompt pay law took effect this year.)  
  • About the same time, Congress and federal Medicaid officials took steps to dramatically reduce Medicaid reimbursement for generic drugs to levels well below even the drug acquisition cost – a major financial hit, especially for independent pharmacies that serve the highest levels of Medicaid patients. After years of urging by NCPA, there’s now bipartisan support for an equitable fix to the average manufacturer price (AMP) formula. But we still have a long way to go.

Government is now essentially the community pharmacist’s largest business partner, due to the growth of Medicare, Medicaid and other public insurance programs. Even without health care reform, that trend continues, underscoring the need for continued advocacy by community pharmacists.

The recent Supreme Court decision adds a new element: Now large corporations (national pharmacy chains, PBMs/mail order pharmacies, etc.) can spend much more freely in supporting specific candidates. Individual pharmacies do not have anything close to their level of resources. The “mere” annual compensation of the big three PBM CEOs is by itself 35 times what the NCPA PAC contributed last year.

Advocacy can take a number of forms. Invite Members of Congress and state officials to tour your pharmacy. Join grassroots efforts to educate policymakers about the value and importance of community pharmacy.

We’ve only scratched the surface. For example, only a relative handful of pharmacy owners contribute to the PAC. Their actions have made a huge difference but still there is much more that needs to be done.

Therefore, it’s even more important to get involved with NCPA today.

9 Responses to “‘Get into Politics or Get Out of Pharmacy’”

  1. 1 Jim Fields February 19, 2010 at 4:54 pm

    Would someone please “Wake up and smell the Coffee burning” when you have the USA Governors calling pharmacists overpaid “Glorified grocery bag Boys” , the federal government claiming we over charge and charges for service not rendered, when you have most all National Unions like UAW, Federal Employees, IUE, State Teachers, Public Employee Retirement Systems, and so on saying we add only expense and no off setting professional value and thus choose mail order delivery as an equivalent but cheaper alternative to “point of service” Rx distribution. When you have every major manufacture using mail order as the Rx distribution method of choice, ————-Then I ask: when are you going to wake up to the fact that there is a new day and the new day needs a new business model and new marketing strategies for community pharmacists? The above facts are abslute proof that polictically pharmacists can not compete, and in my opinion we should not compete in the political arena.

    Pharmacy can no longer afford to look for political solutions. We need strong aggressive business leadership, producing strategies’ that will market the facts that POS drug distribution is more patient friendly and has better health outcomes than mail order.
    GM, Ford and their Unions do not want to talk to lobbyists, they do not want to hear how bad mail order is, they want to hear how good we the pharmacist are for them. They want us to implement a business plan that proves; that we can reduce cost, improve health outcomes, and be patient/employee friendly, and that their businesses and unions can implement the plan with no unexpected start up cost.

    The national payers at all levels Unions and Businesses alike have all concluded the old system, the one that we pharmacist nostalgically cling to, has failed them. When only the PBMs and Mail Order Pharmacies are presenting an alternative business model for National Manufactures and National Unions to choose from, then of course they pick to use PBMs and Mail Order.

    Remember their sentiment is that any change has to be better than pharmacies old and now outdated business model, which we presently argue and whine for.

    When and where is our new business model; based on POS.DSM, MTM, and the new strength of our Pharm. D. graduates, it is no where to be seen or herd on the market places radar, instead it is drowning in academia and politics…………
    There is a business plan let’s use it http://www.ApproRx.com
    Jim Fields ApproRx

  2. 2 Adam J. Fein February 21, 2010 at 12:56 am


    The ultimate irony for NCPA is that the biggest and most well-funded advocate of face-to-face pharmacy consultation (instead of mail order) is…CVS Caremark.


  3. 3 The Redheaded Pharmacist February 22, 2010 at 8:46 pm

    Pharmacist must prove their worth to the healthcare system. We must show that not only do we have the capability to provide services such as MTMs but we must also prove that those services have value and can save healthcare dollars. If we can do that then we will embark on a new era for the profession of pharmacy. If we can’t show our value and our reason to exist then our profession is in danger of extinction.

  4. 4 Jim Fields February 22, 2010 at 10:08 pm

    We here at ApproRx are in total agreement with the redheaded RpH

  5. 5 Todd Eury February 24, 2010 at 9:12 pm

    The latest blog posting from Drug Channels – a blog authored by Dr. Adam J. Fein was titled “The Politics of Pharmacy”.
    Here are my thoughts:

    Dr. Fein,
    Since I began reading Drug Channels consistently – (about 3 months) I have enjoyed reading your “no-pulled-punches” approach to an industry that at times seems cloudy – at best – missing the transparency mantra that “we’re all in it together to do what’s ultimately right for the patient and better healthcare.”

    I have also noticed that on several occasions you seem to be ANTI-NCPA and certainly ANTI-Independent Pharmacy. (FYI: I capitalized the “ANTI” to accentuate it. Ha-ha) I don’t think – although I could be wrong – that you talk with independent pharmacies every day. I talk with 20 – 40 private business owners/ independent pharmacies every week. They are all – in some way – struggling to be profitable businesses and are constantly (and I do mean – every week) struggling with some new regulation, HIPAA challenge, discriminatory pricing model, new state-law mandate, Medicare Part B cuts, DME certifications costing thousands (One owner shared with me his small town pharmacy paid $30K), and the Mail-Order/ Walgreens/ CVS/ Wal-Mart Pharmacy Empires. The NCPA is one of the few national organizations helping the independent pharmacy owner – have a “voice” in the land of consumer pharmacy politics overall.

    I agree with your comments about lack of innovation – but not in the context that you referenced. Shame on the Independent Pharmacy owner who doesn’t get involved in the fight for their fair share of business – by supporting these national organizations – and demanding that some of their membership dollar be put forth to help steer a sub-committee for true independent pharmacy innovation.

    The whole – purpose of being an independent pharmacy business is to not have to operate, look like, or be limited to the policies and practices of the BIG-BOX-FAST FOOD Walgreens / CVS pharmacy models. (Which is all part of a less caring healthCARE initiative to lessen the importance of the practice of pharmacy, right?)

    You stated in your article: “But is it good public policy or good economics to tilt the playing field in favor of a particular dispensing channel (independent pharmacies) instead of letting the market decide? ” – this is the part that really made me re-read your statement at least twice and then realize you are wrong. Dr. Fein – are you joking?

    Independent Pharmacy IS the way the public across our nation can decide and support the type of pharmacy care they receive. Don’t go to the national chains – and support your local pharmacy and – if that specific local pharmacy isn’t providing your with personalized healthCARE – then go to the next independent pharmacy down the street. Why would you want us to be force to use FAST-FOOD Pharmacy services – or worse yet – (pure) Mail-Order?

    I am a proud supporter of a capitalistic society, the independent pharmacies throughout the country, and the NCPA – and that’s because I do not want to be force to go to Walgreens, CVS, or order my medications from a telephone line. (With the exception of refills, but even then I might want the pharmacist filling the order to “know” me and take the TIME (I do mean – taking his or her time) to review my medications for MY optimal HealthCARE.

  6. 6 Clarence W. Lea, R.Ph. May 10, 2010 at 2:58 pm

    I’ve been a pharmacist for over three decades and witnessed decreasing Rx margins while salaries escalated. At the same time much of the dispensing workload has been replaced by pharmacy technicians and technologies such as robotics. Rx volumes have continued to increase …

    It is time for pharmacists to choose to ‘let go of the vial of pills’. ‘Pills’ have become a commodity at all levels of pharmacy demonstrated by local pharmacists choosing to offer $4 generic programs and signing non-profitable PBM contracts just to hold onto their patients and hope to make a profit on some other ancillary service that is often non-healthcare based.

    Specialty pharmacy is a great example of an emerging arena of patient service opportunity that also provides a great revenue stream. MTMs, DME services, and nutritional services all are rapidly expanding avenues as well.

    As a NCPA PAC member, I’m now in Washington DC attending the NCPA Legislative Conference and fully support their efforts but at the same time I truly believe the future of pharmacy lies in what we know and not what is in those little brown vials.


    Dr C

    Clarence W. Lea, R.Ph.
    Fort Worth TX

  7. 7 Dr.Richard W. Brady December 28, 2012 at 3:08 am

    Until pharmacists grow a back bone they will continue to be the door mat for others who are less educated and trained. While the standardized medical curriculum requires a total of 8 credit hours of pharmacology consisting of 6 credits in general pharmacological concepts and principles and 2 hours of anesthesiology and nurse practitioners and PA(s) take half that amount the pharmacist is required to take a minimum of 60 credits in pharmacology consisting of all its sub-disciplines. Knowing this, you tell me why allopathic physicians, NP(s) and PA(S) have prescribing authority and pharmacists don’t. I will tell you why. Tradition and politics. Simple as that. You want equal recognition? Start by demanding change in you respective state legislature. Base your arguments with facts, not whining. Only pharmacists are qualified to prescribe dangerous drugs to humans. That is your opening argument. Now back it up with research. Trust me its there. Start by performing a comparative analysis of medical and pharmacy school curricula in your respective state focusing on required clinical pharmacology & therapeutics and other required pharmacology courses, not electives. You will find that pharmacist receive 8 to 10 times the training in clinical drug management than any other healthcare provider. It’s way past time to confront the medical and nursing professions and demand our state legislators that they prohibit these untrained and uneducated professions from prescribing drugs to humans. They are not qualified to do so. We have got to stop asking and start demanding backed up with cold hard evidence.

    Dr. Richard W. Brady

    • 8 Jim Fields RPh December 29, 2012 at 6:13 pm

      You’re correct in all points you make. I agree that we need to stay active on the political front but we have to understand the PBMs are contributing immensely more money to their PACs and that the Nursing professions far outweigh us at the ballot box and PAC money .

      Where we as pharmacist can and do win is; academically, technologically, our locations, infrastructure, familiar pathway to health care, and community orientations as you stated.

      Business will listen to our debate of health outcomes and listen better than the policticians. Business is motivated by potential savings not votes.

      Answer to Pharmacy Originations representation failures of the past; no longer solely look for political and/or legal solutions, change Pharmacy Originations to a round world business approach and include a business model approach. Just present the pharmacy business and health facts, which is what pharmacy is, a health business.

      Easy Health Fact Examples: Point of service (POS) drug distribution is more patient friendly and has better health outcomes than mail order.

      Drug Adherence to date has not been handled by anyone effectively but face to face consultation by a community pharmacist has proven far more successful, “when done”, than any form of electronic reminders or telepharmacy programs.

      • 9 Dr.Richard W. Brady December 30, 2012 at 9:07 pm

        Hi Jim:

        Thanks for your reply.

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