Empowering Patients: Independent Pharmacies Advocate for Access and Equity

by Laisha Daley

Laisha is the Chief Marketing Officer for InStockRx.

Independent pharmacies are deeply embedded in their local communities, offering personalized care, building lasting relationships with patients, and advocating for issues that directly impact their patients’ health and well-being.

One of the most pressing issues independent pharmacies are currently tackling is the fight for patient access and equitable reimbursement practices. Their efforts are not only about sustaining their businesses but also about ensuring that patients receive the care they deserve without undue financial burdens.

The Challenge for Patient Access

Access to healthcare is a fundamental right, yet many patients still face significant barriers, particularly when it comes to obtaining necessary medications. Independent pharmacies often serve in rural and urban communities where healthcare options are limited, also known as pharmacy deserts. The presence of an independent pharmacy becomes even more critical to these communities because they are more than just dispensaries; they are health advocates, working to ensure that every patient, regardless of their location or financial situation, can access the medications they need.

However, patient access is being threatened by a range of issues, including rising drug costs, insurance practices, and restrictive pharmacy benefit manager (PBM) policies. PBMs, which act as intermediaries between insurers and pharmacies, have gained significant control over which medications are covered and at what price. This often results in higher out-of-pocket costs for patients and reduced reimbursements for pharmacies, making it difficult for independent pharmacies to remain viable.

A Promise Unfulfilled

The promise and value proposition of the PBMs, in the context of working with payers, was supposed to be in their ability to offer lower costs of prescriptions with zero disruption to the beneficiaries and their network of pharmacies.

On paper that sounds good, but from a patient and pharmacy perspective with real world scenarios, it is hard to say that promise is being fulfilled. Consider these examples:

A recent study published revealed that 3 in 10 adults say they have not taken their medicine as prescribed due to costs.

The latest round of independent pharmacies making the difficult decision to leave the TRICARE network, the U.S. military’s healthcare program. Independent pharmacies are leaving over ‘unsustainably low reimbursement rates, while changes to the program have required some beneficiaries to receive certain medications through Express Scripts’ mail-order pharmacy.’

Temperature-sensitive medications being delivered via mail-order pharmacy as directed by the PBM and sitting outside for hours, potentially compromising the medicine, as shared in a recent Associated Press article.

Zero disruption to beneficiaries? Wrong. Many independent pharmacies would argue that PBMs are shutting off access to medications and creating disruption.

The Fight for Fair Reimbursement

Fair reimbursement is another critical issue that independent pharmacies are fighting for. Reimbursement rates set by PBMs are often inadequate, forcing many independent pharmacies to fill prescriptions at a loss. This unsustainable model puts these pharmacies at risk of closing their doors, which would be a devastating blow to the communities they serve. For patients in the pharmacy deserts, the loss of an independent pharmacy can mean longer travel times to access medications, reduced access to specialized services, and the loss of a trusted healthcare partner.

Independent pharmacies are advocating for more transparent and fair reimbursement practices. They are pushing for legislation that would require PBMs to disclose their pricing models and ensure that pharmacies are fairly compensated for the services they provide.

Further, in addition to advocacy efforts through state and national pharmacy associations like GSPO, NCPA, CPESN and GPOs, independent pharmacies are also taking action through advocacy organizations like Pharmacies United for Truth and Transparency (PUTT), and Coalition for PBM reform.

By fighting for these changes, independent pharmacies are not only advocating for their survival but also for the right of their patients to receive the care that they need.

Empowering Patients Through Advocacy

At the heart of the independent pharmacy’s mission is patient empowerment. These pharmacies understand that when patients have access to affordable medications and the support of knowledgeable pharmacists, they are better equipped to manage their health. Independent pharmacists often go above and beyond by offering medication counseling, wellness checks, vaccinations, and chronic disease management services that patients might not receive elsewhere.

Through advocacy efforts, independent pharmacies are working to ensure that their patients have a voice in the healthcare system. They are fighting against policies that prioritize profit over patient care and are calling for reforms that will make medications more affordable and accessible. By standing up for these issues, independent pharmacies are empowering their patients to take control of their health and well-being.

We are starting to see some movement, with the FTC’s interim report on PBMs published in July, congressional hearings, but PBMs and their lobbying organizations state that the reports are one-sided and based on anecdotes.

InStockRx Empowers Pharmacies Through Insights & Collaboration

At InStockRx, we are passionate about serving the independent pharmacies, helping them serve their patients in the best way possible while also helping to improve their cash flow. We help pharmacies understand their own inventory and provide access to our network of independent pharmacies looking to buy and sell surplus inventory sitting on their pharmacy shelves. We are an option that pharmacies can leverage to source medications in a DSCSA compliant manner and maintain GCR compliance.

We also partner with organizations like GSPO to provide an anonymous, cost-free method to report Medicaid claims reimbursed below NADAC (National Average Drug Acquisition Cost).

Conclusion

The advocacy efforts of independent pharmacies are vital in the ongoing battle for healthcare access and equity. These small but mighty pharmacies are fighting to preserve the personalized care that patients need and deserve. The role of independent pharmacies as patient advocates is more important than ever.

Take Action

Want to share your own experiences or get involved in advocacy efforts? Consider engaging with your state pharmacy associations, or advocacy organizations like Pharmacies United for Truth and Transparency (PUTT).

Are you looking to network and collaborate with other pharmacies? Click here to get started with InStockRx.

by Laisha Daley

Laisha is the Chief Marketing Officer for InStockRx.

ADDITIONAL REFERENCES:

Pharmacy Times: “Challenges in Reimbursement for Pharmacy Services, DIR Fees, and the Evolving PBM Model.”

Drug Topics: “Independent Pharmacies Continue to Face Financial Hardships as the Clock Ticks on PBM Reform.”