COHEN'S CORNER

Don't sell out the value of pharmacy

When did retail pharmacy, and, more specifically, the art and professionalism of dispensing a prescription become a commodity? I'm sure every retail pharmacist has a different answer depending on how new he or she is to the profession; I know I do.

For me, it was back in 1969, when I was just fresh out of school, thinking that pharmacy was the greatest profession in the world.

The store I interned in had its fair share of indigent patients who got their prescriptions filled on what was then a small federal government program known as Medicaid.

It seems like a blur to me now, but I distinctly remember when Blue Cross/Blue Shield announced that it was going to start covering prescriptions for its healthcare insurance subscribers and they were going to more or less follow the reimbursement procedures of Medicaid.

For me, that was when the profession of pharmacy started to sell out its valuable professional services. From that point on, other insurance companies followed suit and it seemed that the value attached to the art of filling a prescription and the professional counseling offered by pharmacists took a back seat to the lowest bidder.

These days, I am more of an observer than a practitioner, but it is incredible to me that 30-plus years since my graduation, no one associated with pharmacy has been able to put a stop to the selling out of pharmacy. Now with the Medicare prescription drug law hanging over retail pharmacy like a dark rain cloud and discount cards finding their way into seniors' wallets, the value of pharmacy has hit a new low.

I have heard all the business arguments from pharmacists as to why it is impossible to say "no" to ludicrous prescription reimbursement plans, I have heard over and over again that "pharmacists are their own worst enemies," and I have heard repeatedly how the practice of pharmacy is going to change. And yet, here we are in 2004, about to have another poorly thought out government-funded prescription program rammed down our throats...ahh, shades of 1969. This time, not only the independents will get hurt, but so will the chains.

I have just returned from the NACDS Annual Meeting, and was encouraged by what I heard from industry and chain leaders alike. The selling out of pharmacy must stop, and it must stop now. I was more encouraged about the future of pharmacy after a speech given by Mary Sammons in which she spoke of the "value of pharmacy" (see "NACDS chairman urges chains to promote value of R.Ph.").

Ms. Sammons is the president and CEO of Rite Aid, one of the leading pharmacy chains in this country. As a pharmacist, I have to respect the president of any chain speaking publicly about pharmacy, but when it's a chain as large as Rite Aid that's giving utterance to the importance of pharmacy, that is impressive and gives me hope. You have to respect Ms. Sammons when she says, "We need a change in our culture." And while I understand she is also the chairman of NACDS and is to some extent touting the party line, she also exemplifies what is needed to save pharmacy in general. She says we "must invest to prepare our pharmacists" and make sure that "retail pharmacies remain a viable choice despite whatever uncompromising program is thrown its way."

I hope that Ms. Sammons makes good on her promises and strategic plans for pharmacy in her chain because without stepping up to the plate and taking a swing at the ball, pharmacy is never going to score any runs.

When it comes to the value of pharmacy, we are definitely in the bottom of the ninth inning and way behind on the scoreboard. Now is the time for all of us to rally behind our profession, for both the chain and independent drugstores. If we don't, the game will almost certainly be over before we know it.

By Harold E. Cohen, R.Ph.

 

Harold Cohen. Cohen's Corner: Don't sell out the value of pharmacy. Drug Topics May 17, 2004;148:26.