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Strength in numbers: Advocacy in focus at Cardinal Health RBC 2018

At the Cardinal Health RBC 2018 Opening Session in San Diego, pharmacy owners heard about the ways they can work together to bring change to the current reimbursement model.

Doug Hoey, president and CEO of the National Community Pharmacists Association, and Ritesh Shah, owner of Drug$mart Pharmacy in Keansburg, N.J., spoke to Steve Lawrence, Cardinal Health senior vice president of independent sales, about how independent pharmacies’ strength lies in their numbers when it comes to changing policy.

Hoey noted that progress has been made in bringing to light the reimbursement issues that community pharmacies have with pharmacy benefit managers. He highlighted recent stories from “60 Minutes” and The Wall Street Journal that shined a light on the issue and noted that even President Donald Trump has taken notice of PBMs.

“We can't let up — we're reinventing pharmacy and redefining how we get paid,” Hoey said, noting that NCPA members are bringing some of their legislators to tour their pharmacies and educate them about the reimbursement system.

This direct approach is one way that pharmacies can help effect change on an individual effort, and Shah highlighted ways that pharmacists can do so on a larger level.

Shah, who chairs the New Jersey Pharmacists Association Political Action Committee, said that lawmakers in his state, after listening to a coalition of community pharmacy groups, recently passed legislation focused on maximum allowable cost, or MAC, transparency, as well as legislation that subjects PBMs to state regulation and allows pharmacists to dispute with PBMs through the state, allowing them to enforce contracting standards.

Hoey noted that changing the current payment model, while a victory in itself, cannot be where pharmacy advocacy ends.

“It's really important not only that we succeed in disrupting this current payment model, but that we also offer a solution that redefines how pharmacies get paid,” he said. “That solution is the Community Pharmacy Enhanced Services Network.”

CPESN USA is made up of local, largely state-based pharmacy networks that work together to negotiate contracts with payers as a clinically integrated network. Hoey noted that doing so helps elevate pharmacies to the same level as health plans and other healthcare providers in negotiation, which complements legislative efforts.

“When you put CPESN and the advocacy efforts together, that's how we're going to change how pharmacies are paid,” he said.

Shah said that pharmacies in New Jersey recently banded together to get a Jersey City independent pharmacy re-added to a network by telling legislators the new hurdles for Jersey City patients who might have to travel farther just to pick up their prescriptions.

“We fought hard, our numbers worked and we were able to get the pharmacy back into the contracts,” Shah said. “When you work together, united, it works. The numbers make an impact, but we have to stay focused and organized.”

Hoey noted that in addition to pharmacies being engaged, recent coverage and focus on pharmacy-related issues also is mobilizing patients, who he said can be a key voice to add to those of pharmacists.

“There’s no question staying organized and moving as one unified front makes for a very powerful force,” Lawrence said as he closed the panel. “Change just doesn't happen — we have to get involved to cause change.”
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