Q&A: Life after the NCPA

BY Jim Frederick

After a distinguished, eight-and-a-half-year tenure as chief of the National Community Pharmacists Association, Bruce Roberts, independent pharmacy’s toughest champion, retired June 25 as NCPA’s EVP and CEO. He now is president and CEO of Benecard Services, a small pharmacy benefit manager and prescription benefit facilitator firm founded by pharmacist Richard Ullman. Roberts, a longtime former independent pharmacy owner in Leesburg, Va., brought energy and passion to his role and helped spur a resurgence, both for the organization and independent pharmacy. Under his leadership, the NCPA gained stature as a major lobbying force on Capitol Hill, won a series of key legislative victories, reversed a membership decline, renewed interest in pharmacy ownership among pharmacy graduates and built strong collaborative ties with other pharmacy and health organizations. In an exclusive interview with Drug Store News, Roberts looked back on his years with the NCPA and shared his vision for pharmacy’s future.

Drug Store News: Now that you’ve capped this phase of your career, what are your immediate plans?

Bruce Roberts: I’m going to move back to Leesburg, Va. In my new position, I’m going to open a Washington, D.C., office and stay in the area.

DSN: Can you tell us about your new position?

Roberts: Richard [Ullman] wants to do two things: One is to create a new means to manage the prescription drug benefit that is more aligned with the beneficiary and the payer. And secondly, he’s a pharmacist, and his pitch to me is, “I want to do something to not only save the profession, but [also] really position the profession in a very favorable light in our healthcare system.”

Those have been focuses of mine from day one. As you know, I’ve been a huge critic of the PBM industry, and it probably seems very strange that I’m going over to the PBM industry. But I see it as a logical next step of my work. I came to NCPA focused on making a difference and positioning the industry in a very positive light. Benecard is a fairly small company, with about 300,000 lives and about 300 employees, so it’s an opportunity to make a difference.

DSN: How have things changed at NCPA over the years, and what do you see as the most significant accomplishments, both from the standpoint of your own satisfaction and that of NCPA and community pharmacy?

Roberts: I think we’ve made substantial gains over the last nine years. And one of the most significant gains has been fostering a rejuvenated interest in independent ownership.

When I came to the NCPA, there was very little interest in it. Independents’ numbers were dwindling, and there were very few new pharmacies opening. So that’s been a significant change, because now there’s a tremendous interest in independent ownership. We’re opening up about 100 new pharmacies a month, and NCPA’s membership is increasing about 10% a year on average.

The other thing I think where we’ve really made a difference is the increased influence of pharmacists in the political process. We have one of the largest [political action committees] in the country, and a legislative defense fund that’s second to none in pharmacy circles. And we’ve gone from a staff of basically two folks in the political communications area to…as many as 30 people focused in that area.

The NCPA also has become a very strong organization. It’s on solid financial footing, our budget’s increased dramatically, we have more than twice as many staff as when I came here and our membership, having gone through many years of decline, has shown consistent increases.

DSN: What would you like to see accomplished at NCPA over the next couple of years?

Roberts: One place where we haven’t made as many inroads as I’d like is moving to a future where the pharmacist is more an integral part of the healthcare delivery system. That’s one reason for this new gig: It’s going to give me an opportunity to build an engaged network of pharmacists, and to really shake up how the prescription drug benefit is managed. Ultimately, that’s going to be key to that future.

DSN: There’s been a sea of change in Congress’ perception of independent pharmacy. In terms of legislation, what do you see as high points over the last few years?

Roberts: We’ve had a number of wins. Things like prompt pay, inclusion of medication therapy management throughout healthcare reform, the durable medical equipment accreditation issue, the [average manufacturer price] fix [for Medicaid-paid generic drugs]. We really got more in healthcare reform than any other healthcare organization.

I’m not going to begin to take all the credit for that, but I think NCPA had a huge influence on those wins. And the reason was [that] we made a concerted effort to give independent pharmacy…a voice. We took a very methodical approach, building our [political action committee], setting up our legislative defense fund, hosting lawmakers for pharmacy visits, etc. And that has paid huge dividends and culminated in a string of legislative victories.

DSN: It’s also been an era of increasing collaboration with chain pharmacy and other groups, including those outside of pharmacy that are concerned with health issues. Will that trend continue?

Roberts: I think to have an effective trade organization, if you’re not collaborating with the rest of the folks in your industry, you’re making a huge mistake. The devils-and-angels approach doesn’t work.

DSN: Any predictions for when your successor will be found?

Roberts: I doubt there will be anybody in place before October, and it’s more likely to be the first of the year. Doug Hoey, who’s been my No. 2 for many years, is going to take the interim position. He will do a fine job running the organization, and I’ll be there to counsel him as issues arise. I’m committed to remaining active in pharmacy circles.

DSN: Do you still have a financial interest in your own pharmacy?

Roberts: No. Last August I made the decision to sell my last two stores to my employees. So I’m no longer a pharmacy owner, which after 35 years is a little strange.

DSN: If you look out five or 10 years, where would you like to see independent pharmacy?

Roberts: My vision for the industry and the profession is that pharmacists will play a highly integrated role in our healthcare system. Pharmacists will be relied on to take ownership of medication outcomes, and to work collaboratively with the rest of the healthcare team to ensure that prescription drugs are used correctly and you get the desired outcome. That’s my focus, and I have every reason to believe NCPA’s focus will remain the same.


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The Apothecary Shops earns spot on Inc.’s fastest-growing private companies list

BY Alaric DeArment

PHOENIX Diplomat Specialty Pharmacy isn’t the only one to earn a spot on Inc. magazine’s list of the fastest-growing private companies.

The Inc. 5000 also listed specialty pharmacy The Apothecary Shops, ranking 2,394. That marked a jump of 322 spots from last year and 1,682 spots from 2008 in its fourth annual appearance on the list.

Drug Store News reported Thursday on Diplomat’s inclusion on the list.

“It’s no secret that we have undertaken a very aggressive growth strategy for The Apothecary Shops, but our approach, particularly in a down economy, has been targeted and strategic to be in a solid position to leverage that growth when the economy turns,” The Apothecary Shops president Keith Cook said. “Our movement on the Inc. 5000 list of fastest-growing companies reflects the success of our strategic direction.”


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Type 2 diabetes linked with cognitive impairments, study shows

BY Allison Cerra

WASHINGTON A small study conducted by Canadian researchers found factors that may link Type 2 diabetes with such cognitive impairments as dementia.

Older adults with diabetes who also have high blood pressure, walk slowly or lose their balance, or believe they’re in bad health, are more likely to have poorer cognitive functions than those without these problems, according to a new study conducted by researchers at the University of Alberta in Canada and published in the September issue of Neuropsychology

The study of older Canadians — 41 adults with Type 2 diabetes, ages 55 to 81 years, and 458 matched healthy controls (ages 53 to 90 years) — found that systolic blood pressure, a low combination score for gait and balance, and a patient’s own reports of poor health all played a statistically significant role in the relationship between diabetes and cognitive impairment.

“Awareness of the link between diabetes and cognition could help people realize how important it is to manage this disease, and to motivate them to do so,” said co-author Roger Dixon, PhD, of the University of Alberta.

Type 2 diabetes has been found by other researchers to nearly double the risk of dementia and Alzheimer’s disease, said Dixon, who studies how health affects cognition in aging. As diabetes becomes more common, this heightened risk could dramatically hike the number of older people with dementia.

The prevalence of diabetes in the United States for people older than age 60 — according to the National Institute of Diabetes and Digestive and Kidney Diseases — is more than 23%, while Canadian prevalence is nearly 19%, according to the Public Health Agency of Canada.


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