PALM BEACH, Fla. —It rained hard on the third morning of the 2010 National Association of Chain Drug Stores Annual Meeting here, forcing the hundreds of retailers and vendors into The Breakers’ indoor spaces to try to maintain their meeting schedules despite the weather. The storm was an inconvenient reminder that not all things in business can be controlled or anticipated, and it was an apt metaphor for the unsettled, shifting world of pharmacy retailing in an era of health reform, reimbursement challenges and a halting economic recovery.
The chain pharmacy industry, NACDS leaders repeated throughout the four-day event last month, is navigating in uncharted waters—but in a boat made more seaworthy by the efforts of the group and its members. Incoming NACDS chairman Larry Merlo, his predecessor Andy Giancamilli and the organization’s president and CEO Steve Anderson all reminded the roughly 2,000 retail and supplier executives, pharmacy educators, health industry experts and guests who made the trek to Palm Beach that the industry now operates in a time of unprecedented challenges to the healthcare system, unsustainable growth in health costs and the uncertainties of a shiny, new health-reform law. But they also asserted that community pharmacy is far more unified, focused and respected as a contributing member of an integrated healthcare team than it was in years past.
“We realized that we had to stop whining and start winning. We realized that we couldn’t just go into congressional offices and say what we were against,” Anderson said at the conference kickoff on April 25. “And, though reimbursement looms large…we had to describe the way that pharmacy improves lives and saves long-term healthcare costs. So we are. And it is working.”
In his first address as NACDS chairman, Merlo immediately challenged industry leaders to meet health reform head on. He called on the representatives of every retail pharmacy channel to stake their claim to a rapidly evolving healthcare system—a system in desperate need of new, more cost-effective solutions and closer coordination among patients, payers and healthcare providers.
“We must define the value for community pharmacy in a reformed healthcare delivery system,” said Merlo, who also is president of CVS/pharmacy. “If you want to define the healthcare equation as access, cost and quality, I would offer that our industry—community pharmacy—is in the best position to effectively and positively contribute to all three pillars of that healthcare equation.”
Anderson urged attendees to “stay vigilant” as the Obama administration begins to interpret and implement the changes wrought by the health-reform law. But he also cited a list of whole or partial victories for retail pharmacy over the past two years, culminating with the inclusion in the healthcare bill of many of the provisions sought by pharmacy advocates.
Among them: “a much-improved definition and calculation method” for reimbursing pharmacies that dispense generic drugs to Medicaid patients, a conditional exemption on the accreditation requirement for pharmacies selling durable medical equipment and new support for pharmacist-provided medication therapy management services.
In a larger sense, Anderson said, pharmacy also is gaining ground as a full participant in a health-and-wellness “renaissance” shaping the way health care is provided in the United States. “Together, we are creating a renaissance,” he asserted. “I am convinced people will look back 20 or 30 years from now, and will see these times…as a historic, watershed moment.”
Merlo agreed. “As an industry, I believe we are positioned to help control the costs of health care by advocating for the value of what I’m going to call ‘pharmacy care,’” he said. “Our strategy for ensuring the use of cost-effective medications is pretty clear; we need to promote adherence and effectiveness.”
Pharmacy care, Merlo asserted, “is the cost-effective treatment of disease, particularly chronic disease, through better mechanisms to promote adherence and effectiveness. The terminologies have been out there for years: MTM, disease management. It doesn’t matter what we call it; the time is now to examine the trends in the delivery of health care and the role of community pharmacy, not just today but into the future as well,” said NACDS’ new chairman. “Most important of all, we must ensure that the value of the pharmacy industry and its pharmacists is recognized by payer reimbursement policies—not just for the products we sell, but for the services we provide.”
Giancamilli, the outgoing chairman, said the industry’s best days are still to come. “Everything we are doing today truly is creating a legacy of greater success in the future,” he said. “Despite our remarkable progress, I know that NACDS’ greatest work in political engagement lies ahead.”