Your response to 2010 healthcare reform...

Since Congress passed healthcare reform legislation in March, Drug Topics has continued to run its poll asking for your feedback. Overall, your responses to the survey question “Do you feel that the consequences of this legislation will benefit the practice of pharmacy overall?” have been mixed. Forty-seven percent of respondents answered “No” and 53% answered “Yes.” A total of 73 readers have responded.

Comments from respondents who answered “No” included objections to cuts in reimbursement, lower profit margins, staff shortages, government control, inefficient and costly government-run programs, insufficient cost estimates for pharmacies, increase in prescriptions, increase in costs, increase in paperwork, decrease in pay, and decrease in quality of care.

Respondents who answered “No” said:

• “We are now completely dependent on the government to define our role and value to the healthcare system.”

• “Government regulations have already bogged down the pharmacy counter to an almost unbearable level. We are so buried by paperwork: prior authorizations, tier 1, tier 2, tier 3 formulary management, primary, secondary payers, HIPAA, etc., we can’t concentrate on our primary purpose, filling prescriptions accurately and promptly, and advising patients on health, not government or insurance issues.”

• “Show me a country (or even a U.S. state) where it has been done correctly and I will consider it. Show me a country (or state) that has done it correctly, helped patients receive the best possible treatment in a timely fashion, and the system hasn’t been completely bankrupt in no time (by fraud, waste, and abuse), and I will call you crazy. No matter how good you make these ... no matter how hard strength fights for innocence, you are still going to be taken down by the perpetually open hand.”

• “It has taken the freedom away from many people. Many insurances require mail order and this takes away customer choice and customers to the local business.”

• “I believe reimbursements will continue to decline, any PBM transparency will adversely impact pharmacies initially, and AMP as a reimbursement model will not sufficiently account for true pharmacy costs and will be untimely in data contributing to the model.”

Comments from respondents who answered “Yes” included belief that reforms will keep costs down, ensure PBM transparency, increase the number of patients, increase the number of patients with insurance, increase business, increase incentives to perform MTM, increase affordability, increase work, result in better pricing, and eliminate Medicare’s accreditation requirement.

Respondents who answered “Yes” said:

• “Transparency of PBMs, drug manufacturers, insurance will lead to better pricing and practices. Demise of many insurers and controls on the rest will lead to better prices, practices, and overall benefit to finance.”

• “More people that currently could not afford healthcare and prescription coverage now will be able to.”

• “As pharmacy goes, there are some benefits like increased incentives to perform MTMs. Overall though, I worry what this reform will do for our future as Americans.”

• “People currently without coverage should be included, minimizing the number of people that cannot afford their prescriptions. The key issue is having adequate transparency to preclude a high percentage of Rx funds from being siphoned off by the PBMs.”