Let’s agree to turn down the temperature, and turn up the heat

Early in my career, when I was practicing in Alabama there was a bill before the state legislature related to pharmacy technicians. The state pharmacy association strongly supported the bill, yet one of the big hospitals in the state opposed the bill. I can distinctly remember visiting a legislator’s office to ask for support for the bill and the senator said, “Michael, why do you expect me to support something you can’t even get your profession to agree on?” It was a humbling moment.

I’m pleased to say that in Congress this summer there is legislation that the entire profession—pharmacists, pharmacies, health systems, pharmacy educators, managed care plans, and the pharmaceutical industry—agrees on: passage of the Equitable Community Access to Pharmacist Services (ECAPS). We are all on the same page that this legislation (H.R. 1770 and S2477) is a vital component of reforming the payment system. We are now working with House leadership to get a mark-up hearing on the bill. We have received indications that a lame duck session health care package is likely to include our bill. Please take some time to reach out to your member of Congress about the importance of passing the bill when the members are home for August recess. We need the entire profession to be laser focused on getting this bill across the finish line!

This past week an unknown actor at Caremark—one of the big PBMs—wrote and released a white paper through the company’s website. This paper has the potential to undermine the very fight we are about to win and threaten independent pharmacy practice in local communities. The premise of the paper was to defend PBMs and their work in reducing drug costs. However, the report crossed a critical line and instead diminished the credibility and integrity of pharmacists. It’s not possible to separate independent pharmacies from the pharmacists who own them. When someone attacks independent pharmacies, they are attacking the cornerstone of many local communities. This paper is a below-the-belt punch meant as clear retaliation against the pharmacy profession’s efforts to pass different legislation—reform of the drug pricing system (i.e., PBM reform).

This type of attack has the potential to distract and derail the entire profession from our priorities. Those outside of our profession who see us attacking other segments of our profession with sharp tongues may come to the wrong conclusion about us.

Can we turn down the rhetoric? It’s time leaders step up and intervene. We need to be on the same page, as a profession. Let’s put our energies into our legislative priorities. It’s one thing for businesses to fight hard to stay alive, but when that fight turns personal and the individuals (pharmacists) who are attempting to provide care are undermined, then we’ve gone too far.

APhA supports the bills in Congress to reform PBM practices. We are leading the efforts to pass provider status legislation. We think both are necessary to ensure that patients continue to have access to the care services of pharmacists wherever they interact within the health care system. We believe true payment reform requires reforming both the drug payment system and the system for paying for pharmacists’ care services. APhA also believes that we are stronger together.

Sometimes our employers take positions that we as individuals have a hard time supporting. We can disagree, but we don’t have to be disagreeable. We can fight like siblings, but we don’t have to burn bridges. At the end of the day, we are all pharmacy professionals, bound by a professional Oath to serve society. It’s a bond that’s worth fighting for each and every day.

For every pharmacist. For all of pharmacy.