Leading U.S. Senators and Representatives joined independent community pharmacists at a rally for patient choice and pharmacy competition on Capitol Hill Wednesday, May 9th to close out NCPA’s 44th annual Legislative Conference this week.
“We want to continue making the case that the community pharmacist, the small town pharmacist is a very important part of the health care delivery system in the United States,” said Sen. Roger Wicker (R-MS), a co-sponsor of S. 1058, the Pharmacy Competition and Consumer Choice Act. “I know my pharmacist by name. I trust him. I go to him for advice. I can rely on him. And that’s important to me. And it’s important to the millions of Americans who do business with you.”
“I work closely with our community pharmacists,” said Rep. Ruben Hinojosa (D-TX). “To a local community pharmacist, a patient is not just a revenue stream for profits, but a friend, a neighbor.
“Community pharmacists provide diabetes screenings, immunizations for children and work with patients to help manage their medications. It is this kind of personalized service that makes them an invaluable part of our health care system,” he added. “In my Congressional district in south Texas, we face some of the highest rates of diabetes and obesity. Local, community pharmacists are there every day helping patients adhere to their medications, explaining to them how to take medications to improve outcomes.”
The chief sponsor of the Preserving our Hometown Independent Pharmacies Act (H.R. 1946), Rep. Tom Marino (R-PA) also addressed the rally. A three-time cancer survivor, he spoke passionately about how his local independent pharmacist in Williamsport, PA delivered specialized medication to the Representative the evening he returned home from the hospital. Years earlier, that pharmacist helped ensure his daughter, who is battling cystic fibrosis, had the vital medical supplies that she needed when they unexpectedly ran out during a trip to England.
“We need to pass this legislation,” Rep. Marino added. “There’s a groundswell starting now. And we’re getting more and more people attuned to what is going on.”
“You stand up for patient choice and it is because you are the ones who are there, committed to patients’ health,” said Rep. Judy Chu (D-CA), a co-sponsor of H.R. 4215, the Medicare Pharmacy Transparency and Fair Audit Act, which would address several issues related to pharmacy benefit managers (PBMs). “Now that the FTC is not opposing the merger of two of the three biggest PBMs, Express Scripts and Medco, the need for PBM legislation is even more critical.”
“It’s one thing to get the prescription, but monitoring how that medication is working on the individual, the specific person—that’s what takes attention,” he said. “If you have a community pharmacist, you are coming in and you’re talking to that pharmacist,” who’s explaining what the side effects are, what the symptoms are and providing real world information.
Health care today can be very impersonal in many instances, he observed, and independent community pharmacies are a welcome exception to that trend.
“One of the challenges you face if you have the illness is that your very specific situation has to be paid attention to,” Welch said. “And the place where you get that without getting hassled, where you feel alright without imposing on the person who’s giving you the information, is that person behind the counter, who really is genuinely interested, who lives in your community, who probably knew you before you came in to get a prescription.”
“It has to be ultimately an interaction between the patient and the care provider,” he added. “Medication is playing an ever-larger role in the treatment of illness but it doesn’t do it on its own. So the items of legislation that we’re talking about are really about maintaining that connection between that individual and the health care provider.”
“Often times in a small town, the pharmacist may be the only health care professional who lives in that town,” said Sen. Mark Pryor (D-AK), a leading sponsor of S. 1058. “And certainly it’s the one that people see most. You don’t need to have an appointment to go talk to your pharmacist. So it’s a very critical role that they play for health care all over the country.”
Pryor recalled a Congressional hearing he chaired, at which NCPA’s Mark Riley, PD and others testified, that highlighted some of the abuses associated with PBMs. Pryor added, “It’s a system that’s not working well. It’s not right. There’s a lot of inequity in the system. There’s a lack of arms’-length dealing in the system.”
Brian Caswell, RPh, of Wolkar Drug in Baxter Springs, KS spoke of the unique health care challenges in rural communities and the importance of independent community pharmacists there. He encouraged his pharmacist colleagues to speak up to Congress, policymakers and others about the role local pharmacists play. “If the story has not been told, it never happened,” he said.
Caswell recalled filling a prescription for headache medication for a father and his family. The next night the patient returned because the headaches continued. They spoke about potential problems. It was the beginning of a cold winter and Caswell suggested he check his furnace to ensure the carbon monoxide levels weren’t too high in the house.
The patient did that and went back to the emergency room that night to check everything out. The physician told him that one more night in his house would have killed his entire family of four.
The patient came back to the pharmacy, with tears in his eyes, and hugged Caswell.
“He said ‘You saved my family,'” Caswell recalled. “Those things happen to all of us. If that story is not told, it never happened.
“The value of community pharmacy is more than just dollars and cents,” he concluded. “It delivers a very vital role to patients’ safety, their health, to the community and keeping businesses open and keeping people employed.”
Dr. Michael Kim is a pharmacist and owner of Grubb’s Pharmacy on Capitol Hill, which fills prescriptions for Members of Congress, Supreme Court justices and delivers 200 prescriptions around the city each day.
Community pharmacy plays an “important role in the continuum of care in this country,” he said. “We provide better access for our consumers. We provide better outcomes for our consumers. We provide better adherence programs for our consumers. We provide better counseling for our consumers. Basically we provide better everything for our patients.”
He decried PBM practices including below-acquisition cost reimbursements and unfair audits.
“We’re going to keep fighting back and eventually we’re going to win this battle,” he concluded. “It may be a long fight, but I know that we will eventually be on top.”