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Tallahassee Democrat: Bill Mincy: Pharmacists seek continued legislative support

Wednesday, October 30, 2013

Can you guess which group of health care providers administers nearly 20 percent of adult flu vaccines each year?

It is the same profession that offers a wide variety of education, prevention and wellness services so patients can feel their best.

These providers are often the most accessible in their neighborhood. And they regularly rank in the top tier of the nation’s most trusted professionals in Gallup polls.

The answer might surprise you, but it’s pharmacists.

Since October has been Pharmacist’s Month across the U.S., let’s give pharmacists their due.

Pharmacists in more than 4,000 Florida locations fill about 235 million retail prescriptions each year, an average of one per person, per month. They also offer preventive health services such as seasonal flu vaccines and health screenings so patients can find out whether they are at risk for conditions such as diabetes and heart disease.

Pharmacists are also skilled at helping patients with chronic conditions get the greatest health benefit from their medications through medication therapy management (MTM) programs and other medication adherence services. In the process, they are helping fix a problem — poor medication adherence — that costs the U.S. health system billions of dollars every year.

These professionals are also being used to tackle other tough public health problems, such as low immunization rates.

The Centers for Disease Control and Prevention encourages the use of pharmacists as immunizers to improve vaccination rates, because of their reach into diverse neighborhoods where there may be gaps in vaccine access.

The Florida Legislature agrees, wisely passing the Vaccine Access Act last year to allow pharmacists to administer shingles and pneumonia vaccines in addition to flu shots. This simple step will increase access to these lifesaving vaccines for countless state residents. In the coming years, it would be great to expand this to allow pharmacists to vaccinate more Floridians for more diseases.

Two other top priorities for the pharmacy community during the 2014 legislative session that you may not even be aware of will be reforming the process by which pharmacy benefit managers (PBMs) audit pharmacies and how they reimburse for the drugs that pharmacies have to purchase to serve their patients.

PBMs are the unknown middlemen of the pharmacy world. Their job is to control price and prevent fraud, waste and abuse in the system, which they do through creating lists of reimbursement levels for generic drugs plus auditing pharmacies.

The problem is the lack of government oversight into these processes. PBMs use a maximum allowed cost (MAC) list to set the reimbursement levels for generic drugs, and from that starting point it is a one-way street. The pharmacies often aren’t allowed access to this price list until the prescription is filled, or they can’t find a quality generic drug from their national or regional wholesaler at or below the MAC price, and the PBMs often don’t update their lists to reflect changes in manufacturer price increases, which can be dramatic.

Also, in the absence of any standards for conducting audits, PBMs are treating pharmacies unfairly: not giving reasonable audit notice in advance, not allowing staff to address discrepancies or appeal adverse findings, and even levying penalties for minor typographical errors and misspellings. Legislating clear audit standards and requiring transparency and weekly updates to the MAC lists will end these practices and allow pharmacists to keep their focus on patients.

Patients can feel good about the care they are getting at their local pharmacies.

Every visit is an opportunity to be vaccinated against the flu, to be offered health information or counseling, and to be screened for diabetes or high blood pressure and to be referred to a physician for appropriate treatment. So, during Pharmacists Month, or anytime, drop by your local pharmacy and see how your pharmacist can help improve your health.

Bill Mincy, BPharm, is the vice president of business development at PPSC, a pharmacy services firm serving independent pharmacists in Florida and throughout the country. He also is a spokesman for Pharmacy Choice and Access Now (PCAN).

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