Pharmacy ratchets up pressure on PBMs
Community pharmacy’s high-stakes pushback against the powerful pharmacy benefit management lobby continues.
Last Wednesday, independent pharmacy owners rallied with lawmakers on Capitol Hill in support of several “patient-friendly” bills now before Congress. Among them: the bipartisan Pharmacy Competition and Consumer Choice Act (S. 1058), co-sponsored by Sen. Mark Pryor, D-Okla., and Rep. Cathy McMorris Rodgers, R-Wash. The bill, which includes provisions requiring transparency by PBMs in pharmacy audits, also has the strong backing of the National Association of Chain Drug Stores.
On Capitol Hill, independents also voiced support for the Preserving Our Hometown Independent Pharmacies Act (H.R.1946), introduced in the House by Rep. Tom Marino, R-Pa. The National Community Pharmacists Association’s CEO Doug Hoey called both legislative proposals “common-sense, bipartisan bills” that would “rein in some of the most egregious behavior of pharmacy benefit managers [and] help level contract negotiations between PBMs and pharmacies.”
On Friday, the chain pharmacy lobby again weighed into the debate over the power of PBMs, endorsing the newly enacted Pharmacy Audit Integrity Act in Alabama. NACDS president and CEO Steve Anderson asserted the new law also would “ensure transparency in the PBM audit process.”
Meanwhile, retail pharmacy operators will have to be vigilant in their efforts to keep their own houses in order while they draw attention to PBM industry practices and billing methods. The Department of Health and Human Services’ Office of the Inspector General is looking at possible fraud by a relatively small proportion of community pharmacies that fill prescriptions for seniors under the Medicare Part D drug benefit program.
The OIG issued a report last Thursday under the disturbing title, “Retail Pharmacies with Questionable Part D Billing.” That prompted a quick response from Hoey, who noted that “for approximately 96% of community pharmacies the OIG report identified no ‘questionable’ billing.”
What’s more, NCPA’s top executive said, “Regarding the small percentage of pharmacies that the OIG report focuses on, it lacks sufficient detail to evaluate the medical legitimacy and appropriateness of the claims reviewed.”
Let us know what you think. Is pharmacy fraud a widespread and legitimate cause for concern by Medicare administrators and federal budget overseers? Or is much of the problem due simply to factors outside the control of pharmacies, particularly independent owner/operators, who “struggle to comply with a wide array of inconsistent oversight and auditing requirements,” in Hoey’s words?
Schnucks opens specialty pharmacy at Illinois hospital
SPRINGFIELD, Ill. — Schnuck Markets is opening a stand-alone pharmacy at a hospital in Illinois with an emphasis on specialty pharmacy services, the supermarket operator said.
Schnucks said the 2,000-sq.-ft. pharmacy at the pavilion of St. John’s Hospital in Springfield, Ill., would be its first stand-alone specialty pharmacy in Illinois, specializing in such conditions as HIV, hepatitis, autoimmune disorders, organ transplants and cancers. The pharmacy replaces the specialty pharmacy at a nearby store, though the store’s traditional pharmacy will remain.
"Often, the medications that treat these conditions are expensive, require special storage conditions and need prior approval from insurance providers," Schnucks pharmacy supervisor Dave Chism said. "Schnucks understands this and offers several services to assist these patients. The pharmacies work hard to coordinate benefits and care between the patient, physician and insurance provider."
The pharmacy will serve patients and staff of St. John’s, as well as the general public, the company said.
Harris poll: Walgreens tops among drug store retailers in brand equity
NEW YORK — Consumers gravitate toward traditional pharmacies for their everyday health-and-wellness needs, according to the "2012 Harris Poll EquiTrend" survey released Monday. Among retail pharmacy operations, Walgreens enjoyed the greatest brand equity among consumers based on top consumer scores in "familiarity" and "purchase consideration" categories. Overall, Walgreens’ brand equity was tabulated at 69.9, CVS/pharmacy came in at 67.4 and Rite Aid 62.5.
Pharmacies in the "drug store brands" category also included Costco, Kmart, Target and Walmart. This is the first year that Harris Interactive polled consumers around drug store brands.
In the "value retailer" category, Target was rated higher than Walmart. "Top scores for all three elements of brand equity — ‘familiarity,’ ‘quality’ and ‘purchase intention’ — drove this strong performance," Harris Interactive stated. And Costco debuted as the "Gasoline Retail Brand of the Year."
The Harris Interactive consumer survey uses a brand equity model with elements like familiarity, quality and purchase consideration to help quantify a brands’ connection with consumers.
The study was conducted online from Jan. 31 through Feb. 20, 2012, and analyzes the responses of more than 38,500 consumers on key measures of brand health — including how well the public knows a brand, how positively they think of the brand and their consideration to do business with or donate to a brand. Each brand is rated 1,000 times among respondents who are familiar with the brand. Harris Interactive has conducted its EquiTrend study regularly since 1989, and can offer yearly trended data from 2005. The Equity Score, a key takeaway from EquiTrend, has been validated against financial performance by Georgetown University, Harris Interactive stated.