Independent pharmacies must unify to fight PBM industry

The independent pharmacy industry needs to unite and develop an internal public relations campaign to mobilize pharmacy store owners and patients to fight for their prescription rights. This was one of the suggestions made during a PBM Discussion Panel for Independent Pharmacy, a live discussion from the 2011 PDS Conference in Orlando, Fla., on Friday.

In recent years, independents have lost ground to the pharmacy benefit management (PBM) industry despite lobbying efforts to regulate the practices of pharmacy benefit administrators, according to Dan Benamoz, RPh, CEO and owner, Pharmacy Development Services Inc. (PDS), the sponsor and moderator of the PBM discussion panel and author of a white paper about how to combat PBM abuses, such as manufacturer rebates, spread pricing, repackaging, and the development of PBM-sponsored mail-order programs that compete directly with retail pharmacies. The white paper is posted at www.pharmacyowners.com/preservepharmacy.

“Over the course of the past decade, retail pharmacists have spent tens if not hundreds of millions of dollars on Capitol Hill, lobbying Congress unsuccessfully to classify pharmacy benefit managers as fiduciaries [persons to whom property or power is entrusted for the benefit of another] or at a minimum, for government regulation of this industry,” wrote Benamoz in the white paper. “Under the ‘watchful eye’ of these unregulated guardians of the United States healthcare system, prescription drug costs have escalated over the last 15 years at such an unprecedented rate that basic healthcare is rapidly becoming less and less affordable for individuals and corporations alike.”

More than 200 participants in the PDS Conference and more than 150 online attendees listened to the 5-member panel discuss ways for independent pharmacies to fight back. The panel included Jennifer Bacon, Esq, an antitrust attorney with Poisinelli Shughart PC; Rich Masters, partner, Qorvis Communications, a specialist in media relations; Douglas Hoey, RPh, MBA, senior vice president, NCPA; Mark Riley, PharmD, a member of the NCPA Executive Committee and executive vice president, Arkansas Pharmacists Association; and Dave Gilmore, PhD, president of KeyCentrix Inc.

“You [the independents] have all the elements of a really good campaign - a single message, an energized base, and a really good enemy [the PBM industry],” said Masters in his opening remarks. “This is your fight. You must have the will, desire, and business acumen to engage pharmacies, customers, and your communities. You have the best story to tell - go tell it."

Getting the membership involved is probably the most difficult step, said Masters. “You need to create an environment that will get the pharmacies and patients involved. Once an initiative is started, do news events across the country, and coverage [by the media] should be funneled into the online world,” he said.

Some strategies addressing PBM practices that were mentioned during the panel discussion included state and federal regulatory efforts, the development of a super network, education of the public with talking points, and the direct engagement of small business owners who are affected by PBM practices.

In the state of Mississippi, a bill introduced in the House proposes to move the regulatory authority (over PBMs) from the Department of Insurance to the State Board of Pharmacy, which will be responsible for overseeing and issuing permits to every PBM. Fortunately, the State Board of Pharmacy understands the industry and some of its members are friends of independent pharmacy, according to a pharmacist in the audience who spoke during the panel discussion.

The NCPA has lobbied for greater PBM transparency requirements, which will be implemented in 2014 with the state health insurance exchanges established by the Patient Protection and Affordable Care Act of 2010. “We need a strong offense to keep constant pressure on the PBM industry despite the fact that they are always changing their business models and adapting,” said Hoey.

Another possible strategy is the development of a network to inform other pharmacies of the local initiatives that are taking place across the country. “Grassroots efforts are critical, and you need to demand your GPOs [group purchasing organizations] are part of this network,” Hoey continued.

Another pharmacist in the audience suggested that pharmacies recognize the value of social media in reaching out to the public. “We need talking points to inspire the public. We need to explain that these PBM practices are screwing employers, and some organization needs to spearhead this,” the pharmacist said.

“We also need to educate business owners about their mail-order programs and PBM contracts. Pharmacists need to engage them about their prescription drug program and become a sales force,” said Riley. “We need to be active messengers pushing state legislatures, city governments, and the FTC [to get the word out] about the PBM industry.”

To view the PBM Discussion Panel for Independent Pharmacy, visit www.pharmacyowners.com/PBMpanel.