Community pharmacists on the front lines can be very powerful advocates for their profession and their patients by offering first-hand account. For example, a Montana pharmacist recently wrote what could be considered a model letter to U.S. Senator Jon Tester (D-Mont.), articulately making the case for Congress to act to allow small pharmacies to continue providing diabetes testing supplies to seniors.
Among NCPA’s top legislative priorities is passage of H.R. 5235, the “Medicare Access to Diabetes Supplies Act.” The legislation allows community pharmacies to continue supplying diabetes testing supplies to Medicare patients through an exemption from a bidding program. As currently structured, the bidding program makes it virtually impossible for small pharmacies to qualify, favoring large chains and mail order vendors. For seniors in underserved areas, this may effectively eliminate their ability to have a face-to-face consultation about properly using these products to maximize their health.
Eric Shields of Eastgate Drugs in Missoula, Mont., eloquently applauded Senator Tester’s leadership on passing a Durable Medical Equipment accreditation exemption in health care reform legislation and urged him to introduce a version of H.R. 5235 in the U.S. Senate.
“Dear Senator Tester:
“First, I want to thank you for all your leadership in helping to get pharmacists exempted from DME accreditation requirements in the new health reform law. Your tireless efforts on this issue mean that small independent pharmacies across Montana and across the country will not have to go through an onerous and costly process to serve Medicare patients with diabetes.
“I am writing to ask you to consider introducing the Senate version of H.R. 5235, the “Medicare Access to Diabetes Supplies Act.” … The bidding process is built on large companies competing for quantity and forgetting all about the quality of service. I am asking for your support of independent pharmacies and their patients to introduce this bill into the Senate.
“Eastgate’s MDE billing to Medicare for the last year only accounts for 0.5% of our total sales. … Fortunate for Montana, it is very unlikely that the competitive bidding process will affect us since our ‘metropolitan area’ is less than 200,000. However, there are already suggestions being made in Congress that the supplying of diabetes products may go to a national mail-order service. This would definitely affect Montana and would force our customers to use mail-order. The mail-order service does not save money to the system, especially when we figure in outcomes measured in dollars by hospitalizations and excessive doctor visits due to misuse and poor monitoring by patients. Mail-order pharmacies providing these services to increase sales and volume is poor patie4nt care and will end up costing taxpayers too much money and possibly lives.
“Just as you would walk into your hometown pharmacy to get supplies and medication, many families across our nation do the same and depend on the quality of service of their hometown independent pharmacy. It does not make sense to put these pharmacies through the DME competitive bidding process because they are unfortunate enough to be located near a 200,000 metropolitan area or to let our government force our patients in Montana and across the nation to use a national mail-order service. Small independents who already struggle from neighboring large chain competitors and suffering the many abuses of PBMs will more than likely be forced to surrender their patient’s prescriptions to mail order.
“Mail-order companies are providing test strips to many of my patients already. I had a patient ask me once if I knew of anyone that used a certain type of test strip since she had a surplus from the mail-order pharmacy. Her mail-order pharmacy automatically shipped hundreds of strips to her and she had recently switched glucose meters. Mail-order pharmacies automatically ship diabetic testing supplies creating a very wasteful system. In addition, I end up counseling these patients on correct usage of a glucose meter and how they should be testing. Hence, I provide free services to mail-order patients when the mail-order pharmacy is making all the profit.
“I have had three patients in the past few months complain that their glucose meter wasn’t’ functioning correctly only to find out that they have been reading their results in moles (mmol/L) and not the traditional (mg/dL) measurements by incorrectly setup of their meters. This would result in under treating their diabetes which ultimately leads to more hospitalizations, poor quality of life due to adverse complications such as retinopathy, kidney disease, and neuropathies, cardiovascular complications, and much higher healthcare costs per individual.
“I urge you to please introduce this bill into the Senate to protect independent pharmacies and their patients around the nation. We need to support the hard working business man/pharmacist that gives back to their community by providing face-to-face counseling to patients as well as the pharmacists that visit their non-ambulatory patients at their home to trouble-shoot their glucose machine and discuss their diabetes.”