SUNDAY, JULY 22, 2012 • THE BULLETIN
G5
Benefit managers seen as a threat to small drugstores By Joan Verdon The (Hackensack, N.J.) Record
HACKENSACK, N.J. — In Palisades Park, N.J., Michael and Louis Giannantonio are trying to keep their 57-yearold family-owned drugstore healthy with a recipe their father taught them: friendliness and service. In Cresskill, N.J., Sree and Satish Vattimilli are hoping home deliveries and consultations and greeting customers by name will immunize their store from the competition. In Haworth, N.J., Bill and Denise Hayes are counting on a dose of high-tech innovation mixed with an old-fashioned mom-and-pop style of doing business to keep their pharmacy alive. Independent drugstores fill hundreds of prescriptions a day for ailments such as diabetes, migraines and ear infections. But store owners say they won’t be able to continue doing that unless they find a remedy for the intense pressure they are feeling from a system that squeezes their profits and gives new competitors an unfair advantage. They’re not so much worried about the proliferation of chain drugstores or the bigbox discounters as they are the pharmacy benefit manager companies that were born about 30 years ago to process prescription claims for insurers and have grown into giant corporations that control what drugstores can charge. Sometimes, they even compete with pharmacies through their own mail-order operations. “We lose patients every day to mail order, specialty pharmacy, restricted networks and other methods that the PBMs use to drive prescriptions to their own businesses,” said Matt Kopacki, owner of Rock Ridge Pharmacy in Glen Rock, N.J. “The system is stacked against the local pharmacy, and in some cases, even against the national chain drugstores.” “One of the elements of unfairness of these prescription benefit programs is that the same companies who design the programs own the mailorder pharmacies to which patients are directed,” said Daniel Hussar, a professor at the Philadelphia College of Pharmacy and author of “The Pharmacist Activist” newsletter. Some patients, particularly
those using expensive medicines for chronic conditions, are told their only option is to have the drugs delivered by mail. Others are urged to switch to mail order to be eligible for a lower co-payment. The recent merger of two of the largest pharmacy benefit managers — Express Scripts in St. Louis and Medco in Franklin Lakes, N.J., — and the 2006 merger of the drugstore chain CVS with the pharmacy and benefits manager Caremark have focused attention on the role of these companies. Lawmakers in a number of states, including New Jersey, have proposed legislation to limit or regulate PBMs. Laurie Clark, a lobbyist for the New Jersey Pharmacists Association and the Garden State Pharmacy Owners, said those groups support a bill introduced by Linda Stender, which among other things would prohibit pharmacy benefit managers from requiring someone to fill their prescription at a specific retail pharmacy or at a mail-order pharmacy. “It’s one thing if a patient wants to go to mail order,” Clark said, but many patients are told their prescriptions can be filled only by mail order. “They lose access to their local pharmacist,” Clark added. “Having that access is something we feel is very important to health care.” The National Community Pharmacists Association, a Virginia-based lobbying group, on Wednesday kicked off an attack on the benefit management companies with a website (whorunsmydrugplan.com) and a video intended to mobilize sentiment against them. Brian Henry, a spokesman for the Express Scripts, noted that PBMs save their clients — the employers and insurers — money on their prescription drug plans. “We believe we have a very good relationship with pharmacies, with independents and chains and every other type of pharmacy,” Henry said. “We think we offer very fair reimbursement.” Since 1990, the number of independent drugstores in the United States has declined 28 percent, to 23,064 from 31,879. The number of chain drugstores has increased 11.6 percent in the period, to 20,804 from 18,638.
Fernando Salazar / The Wichita (Kansas) Eagle via The Associated Press
Wheat harvesters work on a field near Clearwater, Kan., on May 28. Some Midwest farmers are planting secondary crops in fields cleared of much-earlier-than-usual winter wheat in hopes of turning the crops into a feed source for cows.
Farmers get creative to ease burden of Midwest drought By Karen Herzog Milwaukee Journal Sentinel
BELGIUM, Wis. — While many Wisconsin dairy farmers worry they won’t have enough feed for their cows this winter if the severe drought doesn’t break soon, Matt Winker has a plan. “A plan and a prayer,” the 31-year-old Ozaukee County, Wis., dairy farmer said last week. “I’ll either look like a hero or a fool.” Some farmers likely will be forced to sell off cows they can’t feed or buy expensive hay and corn from elsewhere. But Winker is gambling on an opportunity created by another crop that’s actually thriving in Wisconsin this summer: winter wheat — the amber waves of grain that summer vacationers see aplenty while driving across the arid Plains states of Kansas, North Dakota and Montana. A mild spring and a little rain at the right time in June made for an early and bountiful winter wheat harvest in Wisconsin, perhaps the best in decades. The early harvest gives Winker and other farmers an extra few weeks of growing season to do something virtually unheard of in this part of the state. Winker is planting soybeans in mid-July on 100 acres of fields cleared last week of much-earlier-thanusual winter wheat in hopes
of turning it into a feed source for his cows. Harvested winter wheat fields generally are left empty until they’re replanted the next spring in a crop rotation with alfalfa, corn or soybeans. In Wisconsin, winter wheat is grown mostly for straw bedding to keep dairy cows comfortable. Winker figures he’s gambling about $6,000 with the extra soybean crop, including seed and labor. Other farmers are devising their own drought plans, planting oats and peas over harvested wheat fields or over withered, immature cornfields cut midway through the growing season for use as cattle feed because the plants won’t reach maturity now, even if it rains soon, local agriculture specialists said. “We’re getting a lot of calls about land where corn was bad and it was harvested early, so they want to plant a second crop, or the wheat ground is open to do some seeding,” said Randy Shaver, a University of Wisconsin-Madison professor and UW Extension dairy nutritionist. Fall oats and peas may be the most common second crops planted in hopes of getting something off the land to feed cows, Shaver said. “People have also looked at short-season corn to plant as silage,” he said. “The real
challenge is having a crystal ball to tell you whether you’ll get moisture or not so the new crop will grow.” If his alfalfa and cornfields don’t produce enough feed for his 160 milking cows, Winker hopes to have an extra 100 acres of soybeans he could harvest as forage — assuming it rains in the coming months. If the drought breaks soon, then he could have an extra 100 acres of soybeans to sell as grain. “You can’t wait until December and say, ‘I don’t have enough feed,’ ” said his father, Tom Winker. “You have to be proactive.” Cows may turn up their noses at eating soybeans, but beans harvested as forage can be mixed with corn and hay so cows will eat it. “If you mix it all together, they don’t know they’re getting carrots,” Matt Winker said, likening it to outfoxing a child who’s a picky eater. Supplements will allow farmers to mix nutritional rations for their cattle, even under the least favorable conditions,
Shaver said. It’s ironic that winter wheat may be a savior in Wisconsin. Wisconsin was the nation’s top grower of wheat in the mid19th century, producing about a sixth of the wheat grown in the United States. But wheat rapidly depleted nutrients in the soil, especially nitrogen, and was vulnerable to insects, bad weather and wheat leaf rust. In the 1860s, chinch bugs arrived in Wisconsin and damaged wheat across the state. As the soil lost its quality and prices dropped, wheat farming moved west. Some Wisconsin farmers experimented with crop rotation and other methods to restore the soil’s fertility, and a large number turned to alternatives to wheat. That’s when the dairy industry emerged and Wisconsin became America’s Dairyland.
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Kevin R. Wexler / The (Hackensack, N.J.) Record
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Louis and Michael Giannantonio work at the pharmacy in Palisades Park, N.J., that was started by their father in 1957.
615 SE Glenwood Drive, Suite 100 Bend, OR 97702
Northwest stocks Name AlaskAir s Avista BkofAm BarrettB Boeing CascdeBcp CascdeCp ColSprtw Costco CraftBrew FLIR Sys HewlettP HmFedID Intel Keycorp Kroger Lattice LaPac MDU Res MentorGr Microsoft
Div PE ... 1.16 .04 .44 1.76 ... 1.40 .88 1.10f ... .28 .53 .22 .90f .20 .46 ... ... .67 ... .80
15 17 8 39 13 ... 9 19 27 15 14 7 ... 11 8 21 8 ... 21 14 11
YTD Last Chg %Chg 35.82 -.67 -4.6 27.60 +.12 +7.2 7.07 -.19 +27.2 20.85 -.61 +4.5 73.89 -.97 +.7 5.50 -.06 +25.6 46.79 -.62 -.8 52.97 -.17 +13.8 95.61 -.34 +14.8 8.46 -.06 +40.5 19.13 -.34 -23.7 18.61 -.49 -27.8 10.01 +.03 -3.8 25.52 -.54 +5.2 7.89 -.03 +2.5 21.47 -.12 -11.4 3.48 -.10 -41.4 10.87 +.18 +34.7 22.77 -.11 +6.1 14.91 -.04 +9.9 30.12 -.55 +16.0
Name
Div PE
NikeB Nordstrm NwstNG OfficeMax Paccar PlanarSy PlumCrk PrecCastpt Safeway Schnitzer Sherwin StancrpFn Starbucks TriQuint Umpqua US Bancrp WashFed WellsFargo WstCstBcp Weyerhsr
1.44 1.08 1.78 ... .80 ... 1.68 .12 .70f .75f 1.56 .89f .68 ... .36f .78 .32 .88 ... .60
Market recap YTD Last Chg %Chg
20 93.08 -2.18 -3.4 16 52.44 -.84 +5.5 21 49.15 +.89 +2.5 15 4.55 -.10 +.2 11 37.22 -.53 -.7 ... 1.60 ... -16.2 35 39.96 -.50 +9.3 20 165.02 -3.32 +.1 9 15.59 -.21 -25.9 12 28.94 -.65 -31.6 26 131.57 -.86 +47.4 10 31.33 -.62 -14.7 30 51.96 -2.24 +12.9 22 5.14 -.19 +5.4 16 12.79 -.05 +3.2 12 33.60 -.20 +24.2 13 15.92 -.02 +13.8 11 33.81 -.34 +22.7 12 19.83 -.15 +27.1 35 23.06 -.01 +23.5
Precious metals Metal NY HSBC Bank US NY Merc Gold NY Merc Silver
Price (troy oz.) $1584.50 $1582.50 $27.279
• Bath Vanities • Mirrors • Ceiling Fans
NYSE
Most Active ($1 or more) Name
Vol (00)
Last Chg
BkofAm S&P500ETF GenElec Pfizer SPDR Fncl
1551280 1274913 1127204 929142 536371
7.07 -.19 136.47 -1.26 19.87 +.07 23.70 -.10 14.38 -.22
Gainers ($2 or more) Name
Last
Chg %Chg
NwOriEd s DoleFood Edenor MexEqt pf WhitingTr
12.91 +1.71 +15.3 10.15 +1.32 +14.9 2.60 +.28 +11.9 16.71 +1.70 +11.3 10.09 +.98 +10.8
Losers ($2 or more) Name
Last
Chg %Chg
Chipotle 316.98 -86.88 -21.5 AMD 4.22 -.64 -13.2 MdbkIns 7.49 -1.10 -12.8 Valhi s 11.37 -1.30 -10.3 BadgerMtr 35.91 -3.57 -9.0
Amex
$1581.00 $1580.10 $27.194
Advanced Declined Unchanged Total issues New Highs New Lows
Nasdaq
Most Active ($1 or more)
Most Active ($1 or more)
Name
Name
CheniereEn GoldResrc Rentech Vringo NovaGld g
Vol (00)
Last Chg
40843 13.78 -.05 38283 17.50 -7.72 30909 2.02 -.03 27465 3.57 -.13 26992 5.66 -.17
Gainers ($2 or more)
Microsoft Intel MicronT Kraft SiriusXM
Last Chg
564903 30.12 -.55 445724 25.52 -.54 441912 5.83 +.05 441443 40.16 -.04 434823 2.10 -.01
Gainers ($2 or more)
Last
Chg %Chg
Name
Last
WizrdSft rs Glowpoint ASpecRlty EntGmg rs MeetMe
2.65 2.22 3.67 2.21 2.01
+.30 +12.8 +.14 +6.7 +.17 +4.9 +.09 +4.2 +.07 +3.6
FidBcPA AstexPhm OnyxPh PacSunwr SanDisk
21.09 +8.31 +65.0 2.52 +.30 +13.5 76.38 +7.98 +11.7 2.21 +.23 +11.6 38.70 +3.62 +10.3
Losers ($2 or more) Last
GoldResrc VirnetX USAntimny Medgen wt AdmRsc
17.50 -7.72 -30.6 35.25 -3.53 -9.1 3.06 -.30 -8.9 6.47 -.58 -8.2 42.77 -3.32 -7.2
Advanced Declined Unchanged Total issues New Highs New Lows
Chg %Chg
Losers ($2 or more)
Name
Chg %Chg
Name
Last
StaarSur Cepheid Rambus UnivFor BldrFstSrc
6.00 -2.08 -25.7 36.01 -7.72 -17.7 4.30 -.92 -17.5 33.99 -6.45 -15.9 4.11 -.77 -15.8
Diary 1,016 2,010 118 3,144 130 39
Vol (00)
Name
Diary Pvs Day
Indexes
Chg %Chg
Diary 179 238 39 456 12 7
Advanced Declined Unchanged Total issues New Highs New Lows
634 1,812 124 2,570 42 49
52-Week High Low 13,338.66 10,404.49 5,487.74 3,950.66 488.43 381.99 8,423.05 6,414.89 2,498.89 1,941.99 3,134.17 2,298.89 1,422.38 1,074.77 14,951.57 11,208.42 847.92 601.71
Name Dow Jones Industrials Dow Jones Transportation Dow Jones Utilities NYSE Composite Amex Index Nasdaq Composite S&P 500 Wilshire 5000 Russell 2000
Last
Net Chg
%Chg
YTD %Chg
52-wk %Chg
12,822.57 5,072.20 489.34 7,759.59 2,380.72 2,925.30 1,362.66 14,257.71 791.54
-120.79 -114.69 +1.36 -90.16 -34.95 -40.60 -13.85 -146.28 -10.63
-.93 -2.21 +.28 -1.15 -1.45 -1.37 -1.01 -1.02 -1.33
+4.95 +1.05 +5.31 +3.78 +4.49 +12.29 +8.35 +8.10 +6.83
+1.12 -6.56 +11.41 -7.71 -2.83 +2.33 +1.31 -.23 -5.97
World markets
Currencies
Here is how key international stock markets performed yesterday. Market Close % Change
Key currency exchange rates Friday compared with late Thursday in New York. Dollar vs: Exchange Rate Pvs Day
Amsterdam Brussels Paris London Frankfurt Hong Kong Mexico Milan New Zealand Tokyo Seoul Singapore Sydney Zurich
Australia Dollar Britain Pound Canada Dollar Chile Peso China Yuan Euro Euro Hong Kong Dollar Japan Yen Mexico Peso Russia Ruble So. Korea Won Sweden Krona Switzerlnd Franc Taiwan Dollar
319.75 2,249.84 3,193.89 5,651.77 6,630.02 19,640.80 40,806.34 13,067.22 3,463.70 8,669.87 1,822.93 3,015.53 4,230.56 5,823.89
-.85 -1.89 -2.14 -1.09 -1.90 +.42 +.13 -4.39 -.63 -1.43 ... -.44 -.14 -.63
t t t t t s s t t t t t t
1.0373 1.5617 .9879 .002049 .1568 1.2159 .1289 .012746 .075002 .0312 .000876 .1441 1.0125 .0333
1.0428 1.5720 .9927 .002061 .1569 1.2278 .1289 .012725 .075608 .0314 .000878 .1445 1.0223 .0333