Industry charts determined course

Is community pharmacy approaching a golden shore of new opportunities, or just trying to steer its way through a rocky and hazardous coastline without running aground?

The answer could be a little of both. With tens of millions of Americans aging and more dependent on medicines, new breakthroughs in medication therapy, the promise of a new era of pharmacy-based clinical care, advances in health information technology and the potential for a vast electronic Web of data-driven collaboration among pharmacists, physicians and patients themselves, the opportunities for pharmacy are tantalizingly apparent. But to reach that potential, chain and independent pharmacy operators will have to overcome a daunting set of obstacles.

Among the most serious:

Massive cuts in Medicaid funding for pharmacy reimbursements, coupled with a new payment formula that critics charge will mean dispensing prescriptions to program beneficiaries at a loss;

Mandatory mail-order programs, which remain a stubborn reality for many prescription drug plans;

A Medicare drug benefit program that allows prescription drug plans to stretch out payments to pharmacies for as long as 45 days or more; and

Continued foot-dragging by most third-party payers in recognizing and reimbursing pharmacists for the value-added, clinical-care services and patient monitoring efforts that save the healthcare system big dollars.

Add to these threats the rise of burdensome drug-pedigree laws in many states, which could force pharmacies to adopt expensive new systems for purchasing, tracking and documenting pharmaceutical inventories.

“Growing concerns about counterfeit drugs are causing states to draft varying pedigree laws,” noted former Walgreen Co. chairman David Bernauer in his first address as the new chairman of the National Association of Chain Drug Stores. “If we allow this to happen without model legislation supported by retailers, wholesalers and PhRMA alike, these laws will become an enormous expense to us all.”

In his first major address to industry leaders as newly installed NACDS chairman and chief executive officer, Steven Anderson acknowledged, “On many fronts, this industry has had a couple of rocky years. You lost some important battles. And the casualties came in terms of your image, your influence and your ability to do business.”

Like most of their industry counterparts, however, both Bernauer and Anderson radiate the tough optimism that typifies retail pharmacy’s most successful leaders.

“To the public, our message is this: Community pharmacy fills a vital role,” Anderson noted. “Don’t underestimate the importance of pharmacists in your own health care. Don’t take for granted the benefit of having access to your community pharmacy for filling your prescriptions.

“To lawmakers,” he added, “our message is this: Don’t discount the essential role we play in the nation’s healthcare delivery system. Don’t balance your healthcare budgets on our backs alone. Don’t mess with an industry that adds tremendous value to the nation and to every community every day.”

What follows is a closer look at three of the toughest challenges facing retail pharmacy—and what may lie ahead.

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