Q&A: Building a Better Future for Community Pharmacy
It is projected between 20% to 30% of all community pharmacies will close in the United States within the next year.1 While there are many reasons for this, community pharmacies across the country have been particularly impacted by opaque and anticompetitive pricing practices of pharmacy benefit managers (PBMs), declining reimbursement for prescription medications, and limited reimbursement for clinical services.
Q&A: Building a Better Future for Community Pharmacy / Zamrznuti tonovi - stock.adobe.com
In a recent commentary published in the Journal of the American Pharmacists Association, Jennifer Bacci, PharmD, MPH, and her colleagues said that embracing the role community pharmacy teams play in patient care and advocating for payment transparency is critical for community pharmacy’s survival.
Bacci, who is the endowed associate professor of Innovative Pharmacy Practice at the University of Washington School of Pharmacy, sat down with Drug Topics to discuss what can be done to shift public perception of community pharmacists, how to address misconceptions about community pharmacy among other healthcare professionals, and how pharmacists can advocate for fair reimbursement and payment transparency.
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Drug Topics: What steps can be taken to shift public perception of community pharmacists from being seen primarily as medication dispensers to trusted healthcare providers?
Jennifer Bacci, PharmD, MPH: I think seeing is believing, and the image that the public has had of community pharmacy and community pharmacists for a long time has been pharmacy professionals behind a glass wall, separated, busy at work, filling prescriptions. I think to change the perception of that, we need to help the public see all the other things that we do beyond filling prescriptions and making sure that medications are appropriate for individuals. I think that's providing the services that are needed in a community and promoting what we do, not only to the public, but also to other providers. I think a great example of that is vaccines. In many states, pharmacists 10 years ago were not seen as the go to vaccine provider. We're now in a very different place. I think we want the transition of public perception to go much faster, and we can use what we learn from vaccines. I think that visibility and promotion of what we do is really important in changing public perception.
Drug Topics: Do you think the general public is aware of the challenges facing community pharmacies?
Bacci: I think the public is more aware of community pharmacy now than they've probably ever been. Whether someone's had to wait in line themselves, wait on hold to get a hold of a team member, whether they've experienced their own pharmacy closing or been told they have to find a new pharmacy because their insurance is no longer accepted, or even if they've heard or read one of the many news stories from traditional media or social media. I don't know that it's really about not knowing. I think it's helping people know what action that they can take. It’s about helping our patients and our communities know that they can reach out to local government, policy makers, and legislators or even that they can report things that they might be unhappy with about their insurance to local government.
Drug Topics: What can be done to address the misconceptions about community pharmacy practice among other healthcare professionals?
Bacci: I think influencing other healthcare professionals starts within our own profession. I think it starts with how we as a pharmacy profession think about community pharmacy, how we talk about community pharmacy and how we value what community pharmacy contributes. There's so much important care that happens in a community pharmacy. I think about working with community pharmacy partners. A lot of our great success stories in recent history have come from pharmacists in other areas of the healthcare system understanding what a community pharmacist team can contribute, and being a champion. We've seen that happen many in instances. Pharmacists within payers help champion some of our community pharmacy enhanced services network, and as a result, those pharmacies are contracted to provide important care to their communities and be paid for providing that care.
Drug Topics: How can pharmacists effectively advocate for fair reimbursement and payment transparency?
Bacci: I think that it's important to show up and to use your voice. If we don't speak up and create our own future, someone else or some other entity will step in and do that. I think it's not only just important to community pharmacy, but it's important to our entire profession and to the healthcare system. I think that that's really important for all pharmacists. I think the challenges that we're seeing in community pharmacy are unique and acute compared to some of the other challenges. But at the end of the day, payment is a challenge across all of healthcare. It's about advocating, speaking up for community pharmacy, because of the urgency in maintaining that access, but also for all healthcare professionals to be fairly and transparently compensated for the care that they provide.
Drug Topics: If current trends continue, what do you foresee as the long-term impact on public health and the broader healthcare system if community pharmacies continue to close at this rate?
Bacci: This is a hard question to think about. I think that the ultimate impact is a negative impact on public health. I think about everything that community pharmacies did during the pandemic with testing, with vaccination, with treatment. It's widely accepted at this point that there will be a future pandemic, a future public health emergency, and what would happen if we don't have the community pharmacy infrastructure to rely on it? The states that strongly integrated community pharmacies into their vaccination plan had the most effective rollout, states like West Virginia, among many others. I think that we will see that our ability to get public health interventions to communities will suffer. But I think beyond that, it will take a toll on the health care system overall and other providers. I think about how often a phone rings and in one community pharmacy in a day because it's where someone can get a hold of a trained healthcare professional the most quickly. What's going to happen if those individuals can't get those questions answered? Where else will they be able to turn to get those questions answered? What will the consequences be to their own health and to their own medication use? I think that will have a strain on the healthcare system and healthcare providers across the system.
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