Pharmacists plead financial plight to state lawmakers

A roundtable discussion was held on the problems facing the profession.

Independent pharmacists such as Robert Maher feel trapped, state lawmakers learned Thursday.

A pharmacist knows the people in the community well, from grandparents to parents to kids, Maher said.

They also know the pharmacy in today’s prescription payment system can’t take care of those people without going out of business.

“It’s sad when you see people you know, and you can’t even fill those prescriptions,” Maher said. He has served for years in leadership roles at Klingensmith’s Drug Stores, an independent pharmacy chain with locations in Leechburg and elsewhere in Western Pennsylvania.

Maher and more than a dozen other pharmacists explained their plight to state Rep. Jessica Benham, D-Pittsburgh; Eric Nelson, R-Hempfield, and Valerie Gaydos, R-Allepo, at a roundtable discussion Thursday at Westmoreland County Community College. It was one of a series of public input sessions held across the state in the past year.

Hundreds of pharmacists are facing a conundrum as they struggle with what they say is the unequal relationship between pharmacies and pharmacy benefit managers — third-party intermediaries between drug manufacturers, pharmacies and insurance providers.

Pharmacy benefit managers reimburse pharmacies for the prescriptions customers buy through insurance.

Greg Lopes, a spokesper- son for the industry group Pharmaceutical Care Management Association, said earlier this year that many things factor into pharmacy closures.

“Pharmacy benefit managers are supporting community pharmacies in rural areas, including Pennsylvania, through programs that increase reimbursements,” Lopes said in a statement. “(Pharmacy benefit managers) recognize the vital role pharmacies in Pennsylvania play in creating access to prescription drugs for patients. A strong relationship between (Pharmacy Benefit Managers) and pharmacies means a better experience and more affordability for patients, which is our top priority.”

Independent pharmacy owners have contended these reimbursements are far less than the actual cost of medications, leading to staggering financial losses for them.

Since the beginning of the year, more than 100 independent pharmacy locations in Pennsylvania have shut down, according to the Pennsylvania Pharmacists Association and the state Board of Pharmacy.

“What you’re looking at is a business that’s just going out of business,” said Michael Sheffler of Precision Care Pharmacy in Greensburg. “They’re getting forced out of business by things out of their control. With that, it affects the customer base.

“Look at it from a macro perspective: the customers are going to suffer. That’s the bottom line.”

Pending bipartisan legislation — House Bill 1993 in the state House and Senate Bill 1000 in the state Senate — would put pharmacy benefit managers under more state scrutiny and limit certain practices that pose some of the greatest challenges to pharmacies.

According to Lopes, the Pharmaceutical Care Management Association will fight the proposed legislation.

Senate Bill 1000 was referred to the Health and Human Services committee in January. House Bill 1993 is up for a health committee vote in two weeks. It was referred to the committee in April.

Benham, Gaydos and Nelson all are sponsoring the House bill.

At Thursday’s roundtable, New Stanton Pharmacy’s Shane Daugherty showed a letter sent last year by a pharmacy benefit manager to his pharmacy’s customers that claimed the pharmacy was no longer in-network.

In reality, Daugherty said, he had, in fact, accepted the contract with the benefit manager, and had to call all of his customers to clear up the confusion.

“We’re not only losing money, but we’re also losing money again with our time, taking the time out of our days on Sundays to call all of these patients to tell them that we actually are in-network,” he said.

“What you’re looking at is a business that’s just going out of business. They’re getting forced out of business by things out of their control.”

MICHAEL SHEFFLER

PRECISION CARE PHARMACY