PROGRESS IS STILL PROGRESS

BY HOPE BROXTERMAN
Pharm.D., president, Michigan Pharmacists Association

Do you ever wonder what the future will bring? Does this ignite anxiety, or hope and possibility? For several years we have been alerted to a shortage of physicians, currently and beyond. Perhaps we did not expect a shortage of nurses, pharmacy technicians and other vital members of health care that has been exacerbated over the past three years. Recently it was reported that one-third of nurses are likely to leave their profession for early retirement or another career due to insufficient staffing, stress that was intensified by the pandemic and burnout. These shortages will unfortunately only intensify as baby boomers continue to age and their need for health care grows. This will cause more strain on an already strained field.

While this may sound ominous, here is a silver lining to consider: pharmacy is in the perfect position to bridge this gap. We can provide needed services by obtaining provider status and regulating pharmacy benefit managers (PBM). Practicing at the top of our license to meet unmet needs is easily in our wheelhouse!

Patients living in medically underserved communities often struggle to access needed care. It is estimated patients visit their community pharmacy three times more frequently than their primary care physician and specialist(s). Recently, the Pharmacy and Medically Underserved Areas Enhancement Act bill was introduced in Congress. If passed, it will allow pharmacists to provide Medicare Part B services such as medication management; management of chronic conditions and related medications; point-ofcare-testing; immunizations; tobacco cessation; and transition of care services. While this bill will not allow pharmacists to provide care for every patient, it moves our profession in a positive direction to obtain provider status.

In order to ensure those who live in rural and underserved communities have access to their trusted pharmacists, community pharmacies need to be able to operate at the height of their capabilities and keep their doors open by being appropriately paid by PBMs. PBM practices such as inappropriate dispensing fees, spread pricing, clawback fees and patient steering negatively impact a pharmacy’s ability to provide much needed patient care – especially in underserved populations.

Fortunately, the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee was encouraged by the American Pharmacists Association (APhA) and other pharmacy partners to ensure PBM legislation protects states’ authority to have meaningful oversight of PBMs while not inhibiting current existing state laws. In addition, a bipartisan group of U.S. House lawmakers have introduced legislation to safeguard patients and pharmacies from PBM practices that curb access to affordable and high-quality health care. The proposed “Protecting Patients Against PBM Abuses Act” prohibits patient steering and spread pricing; bars PBMs from compensating a network pharmacy less than affiliated pharmacies; and allows greater transparency on data related to PBM rebates. While these acts and other bills have not been implemented yet, we are getting closer. We are making progress!

There is a lot of work yet to be accomplished to obtain provider status and regulate PBMs. In order to ensure we continue making progress, I encourage you to join MPA’s Pharmacy Advocacy Response Team (PART) and send your legislators letters when PART reaches out asking for your help. Also, do not be afraid to meet with your legislators to provide education. Recently I met with a group of other pharmacy professionals virtually to educate our legislator on PBM reform. While it sounded intimidating at first, it was reassuring to know that we were sharing information on how not only to improve the practice of pharmacy, but also showed how it would benefit their constituents with the proper care they deserve.

Satya said it best, “A little progress every day adds up to big results.”

REFERENCES:

Harvey, Frank. “Pharmacists Are Essential to Rural Access to Healthcare.” MedCity News, 21 March 2023, medcitynews. com/2023/03/pharmacists-are-essential-to-rural-access-tohealthcare/. Accessed 21 May 2023.

Diaz, Jaclyn. “Nearly a third of nurses nationwide say they are likely to leave the profession.” NPR, 2 May 2023, www.npr. org/2023/05/02/1173107527/nursing-staffing-crisis. Accessed 21 May 2023.

AACN. “Fact Sheet: Nursing Shortage.” AACN Nursing, Oct 2022, www. aacnnursing.org/Portals/0/PDFs/Fact-Sheets/Nursing-ShortageFactsheet.pdf. Accessed 21 May 2023.

APhA. “Pharmacist groups applaud introduction of bill expanding Medicare patients’ access to pharmacist services.” APhA, 10 May 2023, https://www.pharmacist.com/APhA-Press-Releases/pharmacistgroups-applaud-introduction-of-bill-expanding-medicare-patientsaccess-to-pharmacist-services. Accessed 21 May 2023.

United States, Congress, Senate. Pharmacy Benefit Manager Reform Act of 2023. Congress.gov, https://www.congress.gov/bill/118thcongress/senate-bill/1339/text. 118th Congress, Senate Bill 1339, Introduced 27 April 2023.

United States, Congress, House. Protecting Patients Against PBM Abuses Act of 2023. Congress.gov, https://www.congress.gov/ bill/118th-congress/house-bill/2880?s=1&r=5. 118th Congress, House Resolution 2880, Introduced 26 April 2023.