Readers’ PBM perspectives
A guest column in the March 12 issue of DSN, “Let me tell you what PBMs do,” by Republican Utah State Rep. Evan Vickers, really set off a firestorm of debate on DrugStoreNews.com and on DSN’s social media sites. Check out this snippet from two online users with VERY different perspectives on all of this. For Rep. Vickers’ complete column and to add your own views to the debate, click here.
This article is hopelessly hypocritical, biased and unfair. It’s not supported by facts in most cases. In cases where accusations are supported by facts, they are half-truths. There are many clever implications that the author does not actually explicitly state. Here’s a point-by-point of the accusations.
Accusation: As proof of these claims, the ad campaign cites conclusions of a study by Visante that was prepared for the PCMA, the trade group for the PBMs, which is a bit like a defendant hiring his own expert witness.
Comment: The author implicitly accused Express Scripts (ESI) of paying Visante, but offered no attempt whatsoever to support that accusation.
Accusation: PBMs profit at the expense of consumers.
Comment: So what? Doesn’t the author like capitalism? By definition, profit comes at the expense of customers. … It seems there’s another implicit message in this accusation — that PBMs profit at the expense of consumers and that amount of profit is unfair and greedy. That’s false. PBMs are aligned in their interest with the interest of plan sponsors.
Accusation: PBMs eliminate competition from smaller pharmacies.
Comment: Um, I’m … flummoxed. … A market-based economy means there will be winners and losers, unfortunately.
Kurtwz, your response is hopelessly hypocritical and biased. I bet you work for PCMA or some PBM.
1) Express Scripts is a member of PCMA, and PCMA would not print anything that was unfavorable to ESI. …
2) PBMs are supposed to make a profit via the plan sponsors, since they’re the ones paying the PBM. But a PBM that takes a rebate from a drug company is costing consumers. Especially consumers that are not aligned with that PBM. …
3) PBMs eliminate competition from smaller pharmacies. It’s one thing to be eliminated competing against another pharmacy — that’s the free market — … [but] the small independents aren’t being allowed to compete. They’re being handed a contract and told [to] take it or we’ll take away your customers. Sounds more like a mafia protection business than health care.
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RxImpact Day: Now it’s your turn
The fourth annual National Association of Chain Drug Stores RxImpact Day on Capitol Hill wrapped up March 22 on a high note. With pharmacists and pharmacy students from around the country able to secure more than 350 meetings with members of the U.S. House and Senate and their staffs last week, most lawmakers who serve on congressional committees with jurisdiction on healthcare issues got to hear pharmacy’s position on prescription reimbursements, fair payment for pharmacy services and the proposed merger of pharmacy benefit management giants Express Scripts and Medco.
These kinds of outreach efforts to those in power are critical to the future of pharmacy as a profession and a viable industry. Having sat in on congressional hearings and at press conferences with many members of Congress, I can tell you that many of the most influential lawmakers on Capitol Hill still only have a dim understanding of the realities of the pharmacy profession, and of its untapped ability to contribute more fully to the nation’s frayed healthcare network, serve patients more effectively and save billions in healthcare costs.
Pharmacy certainly has its champions on the Hill. But let’s keep in mind that members of the House and Senate are bombarded every day with a slew of national and international concerns and priorities, not to mention a barrage of competing messages from other healthcare stakeholders.
Sometimes, those messages run directly counter to the interests of community pharmacy. One prime example: the pharmacy benefit management industry’s continuing effort to promote the cost-saving benefits, real or imagined, of shifting patients covered by Medicare, Medicaid and the military’s Tricare program into mandatory mail-order pharmacy benefit programs.
There’s also constant pressure to downplay the benefits that pharmacists provide to patients through disease management services, medication therapy management, immunizations and other interventions beyond basic dispensing and counseling. By the same token, the concept of reimbursing pharmacists adequately for those services is under steady assault under the guise of cost-cutting efforts.
Some senators and members of Congress believe them. And many more don’t quite know what to believe. With health costs rising to unsustainable levels, the temptation to cut short-term Medicare and Medicaid costs willy-nilly – by cutting reimbursement rates for generics or for MTM, for instance – must be hard to resist in budget negotiations.
Lawmakers have to be convinced that spending for those and other pharmacy services pays off big in long-term benefits and cost savings. What’s more, they need to be reminded that branded and generic pharmaceuticals remain one of the best bargains in health care, by helping patients manage their conditions and keeping them out of acute-care centers and hospitals.
It’s up to pharmacy professionals and the companies they work for to deliver that message. RxImpact Day is one effective, high-profile way to lobby Congress directly on pharmacy’s behalf, but the campaign to tell pharmacy’s story can’t end when the white coats disappear from Capitol Hill for another year.
If you’re a pharmacy student or a newly minted professional, it’s not too early to get engaged in that campaign. This is a long-term, profession-wide fight for professional standing, a fair reimbursement and a viable future for pharmacy.
To download a copy of the DSN special supplement that went to members of Congress, “Rx Impact: Community pharmacy brings innovation to patient care,” click here.
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Rite Aid launches smartphone app
NEW YORK — Rite Aid has become the latest chain to join the retail smartphone application game.
The Camp Hill, Pa.-based retail pharmacy chain recently launched an app for smartphones that allows users to refill prescriptions by scanning their barcodes or entering the prescription number, transfer prescriptions, manage their Wellness+ loyalty card accounts, view weekly circulars and compile shopping lists, among other features.
The app is available for major smartphone brands including the Apple iPhone and Android phones.