Community pharmacies support structure

The COVID-19 pandemic changed our healthcare system more in the last year than during any period in modern history.

And while the pandemic tested our health-care system, some of the resulting changes have been for the better.

We are finally making it more convenient for patients to access care, more fully utilizing the capabilities and proximity of our community pharmacists.

As a pharmacist with a long history working across the entire pharmaceutical supply chain, I have always believed in the need for greater pharmacist-patient interaction, as well as for policies that protect the livelihood of community pharmacies.

Over the past 16 months, patients have seen the full scope of what pharmacists can do, including administering tests and vaccines and providing medical and medication guidance — all while adapting to the challenges of the pandemic to ensure patients received proper prescriptions and treatments.

To meet pandemic needs, lawmakers across the nation also recognized pharmacists as essential providers, expanding their role within the healthcare system — community support that in retrospect was quite prescient.

The fact is, most Americans live within five miles of a community pharmacy.

These medical professionals have the qualifications and trust of patients to provide specialized medical services that improve care.

Pharmacies also are supported by a vast, often unseen, network of partners, including pharmaceutical wholesale distributors that keep pharmacies shelves stocked, and Pharmacy Services Administrative Organizations (PSAOs) that assist with ever-growing complexities in the pharmacy benefit marketplace. These critical entities provide services that allow pharmacists to concentrate on what matters — patients.

Although they are not widely known, PSAOs are administrative service providers that exist to alleviate the burdens pharmacy benefit managers, or PBMs, create for pharmacies, including handling administrative work and cumbersome contract negotiations.

With fewer regulatory burdens, administrative headaches and hoops to jump through, pharmacists can spend more time behind the pharmacy counter working with their patients.

PSAOs allow this to happen. However, to ensure pharmacists can successfully treat patients, there are still challenges that need to be addressed–particularly among PBMs.

We are thankful to Pennsylvania legislators who have taken steps to curtail some of the hardships PBMs impose on community pharmacies, but it is critical policymakers “keep their eye on the ball” and not redirect their attention due to the coercive actions of PBM lobbyists to PSAOs, who exist to support pharmacies’ abilities to take care of patients.

In my role as head of Value Drug Company, a Pennsylvania-based wholesaler representing many independent community pharmacists and employing over 200 Pennsylvanians, I get to see all aspects of the pharmacy supply chain.

I have experienced the impact that PBMs have on the supply chain, and I know first-hand the powers they wield over pharmacies, especially independents.

PBMs claim they streamline the prescription medication supply chain, managing benefits for health insurers, employers, and even the Medicaid program, and use their negotiating power to reduce the costs for patients.

But in doing so, many significantly constrain pharmacists regarding what they can prescribe and when and how much they are reimbursed.

Despite PSAOs’ best efforts, they have limited bargaining power against PBMs because the PBMs know they have the pharmacy provider marketplace in a bind.

As a result, both PSAOs and pharmacies are forced into take it or leave it contracts with low reimbursement rates, high fees, and little recourse.

As such, pharmacy patients lose. As the national conversation increasingly focuses on pharmaceutical care, it is important the public and policymakers understand the important role pharmacists play, as well as those who truly support them, like wholesale distributors and PSAOs.

Greg Drew is President of Value Drug Company in Altoona.


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