Issues call for profession's renewal

Drug Store News, Sept 13, 2000 by James Frederick

SAN DIEGO -- Pharmacists can do much to improve the lives of Americans, but their skills and potential contributions are too often bottled up by outdated practice restrictions, inadequate recognition and reward for pharmacist services and misperceptions about their role as health professionals, industry leaders said here late last month. What is needed, said one, is "a genuine commitment to fix the future of our pharmacists now, before it's too late."

The occasion was the National Association of Chain Drug Stores' 43rd annual Pharmacy, Managed Care and Technology Conference Aug. 26-30. The event, which was enlarged this year to encompass the explosive worlds of e-commerce and Internet marketing, as well as managed health care, drew more than 2,600 executives to San Diego's waterfront Convention Center for a showcase of new ideas and technologies.

The presence of thousands of pharmacy leaders, faculty members and industry experts and the inclusion of a simultaneous "Bricks2Clicks" conference on Internet strategies made for a content-rich meeting. And given the raft of uncertainties surrounding retail pharmacy, there was plenty to talk about. Among the hottest topics of discussion: the continued throttling of dispensing margins, the difficulties in convincing plan payers and government officials of the value of additional patient-care services by pharmacists, the intractable shortage of pharmacists, the skyrocketing cost of new medicines and the prospects for and possible impact of a Medicare drug benefit.

Conference chairperson Cathy Polley, who is director of pharmacy, government and trade relations for Kmart, summed up the mood of many participants when she said the pharmacy profession is in "a race against time" to re-establish its role and value in the U.S. health system. "We also have to re-establish the image and perception of what, and who, a pharmacist is," she said. "Our patients must recognize that the pharmacist is a healthcare professional, not a pill dispenser behind a counter."

Added Craig Fuller, NACDS president and chief executive, "Pharmacists' knowledge, skills, care for patient well-being and even their accessibility is barely being tapped." Many issues addressed at the gathering--such issues as pharmacy operations and workflow and reimbursement for pharmacy-care initiatives--have at their core the need to "get pharmacists better positioned to help people," he said.

Many at the conference called for greater recognition of pharmacy's value and a closer spirit of cooperation among retail pharmacy leaders, prescription plan payers and other groups in the U.S. healthcare system. "If we can help manage ... patient care ... it really opens up a whole new era of integrated partnerships," said Ed Mercadante, president and chief executive of Familymeds. Like Fuller, he urged a "spirit of cooperation with the PBMs" to overcome the current morass over reimbursements.

With the introduction of new and more complex medications, increasing utilization of prescription therapy and the aging of the population, the need to support those care pharmacy models has become even greater, said Fuller. New payment systems for both government and private health plans, he added, must "appropriately align financial incentives and rewards with society's need for pharmacists to help people make the best use of medication."

"Community pharmacists play an important role in the lives of millions of people each day, helping them to take their medicines safely and with confidence," noted NACDS chairman Alan Levin, who is president and chief executive of Happy Harry's. "We at NACDS and chain pharmacy value our pharmacists and their opinions. And for that reason, we believe policy makers should as well when they debate public policy affecting people and their use of prescription drugs."

Levin said the profession must speak out to counter inaccurate public perceptions about community pharmacy and rising prescription drug prices. "After all, community pharmacies have little negotiating leverage to control rising prescription drug prices," Levin said.