Q&A: Shift in power, 
but not strategy — Steve Anderson, NACDS

The results of the 2010 mid-term elections were dramatic, putting the Republican party firmly in control of the House of Representatives. And the GOP’s “Pledge to America” promises big spending and tax cuts, as well as a repeal of the health-reform law, in direct opposition to the goals of the Obama administration and most Democrats. To gauge the election results and what they mean for pharmacy retailing, Drug Store News interviewed Steve Anderson, president and CEO of the National Association of Chain Drug Stores.

Drug Store News: How will the shift in power affect chain pharmacy, and what should chains be doing about it?

Steve Anderson: Our overall strategy will remain the same, even though I think our tactics will change fairly dramatically as we position pharmacy as the face of neighborhood health care. We have been on that journey for about three-and-a-half years. We knew health care would be a big issue in future years, but little did we know how interesting that would be over the last year.

DSN: How is NACDS approaching the change?

Anderson: This really takes several different tracks. As I’ve said several times, we’re probably in the second or third inning of a nine-inning game in terms of implementation of the [health-reform] law that was enacted this year. That will be left to the regulatory agencies, and obviously the agency we focus on most is [the Centers for Medicare and Medicaid Services], which is now headed by Dr. [Donald] Berwick, who is a recess appointment, which means he was not confirmed by the Senate. So that will take its course.

The rather dramatic changes in Congress ... will really change our focus in terms of how we address pharmacy issues on Capitol Hill. One thing we did three years ago is to make sure our message is bipartisan in its approach. Obviously, we were working with the Democratic majority in the House and Senate in the 111th Congress. But the writing was on the wall with this election, ... and we have made a concerted effort in the last six months to be up on the Hill, talking with the people we thought would be future Republican leaders in health reform.

DSN: Who has NACDS focused on?

Anderson: We had an excellent meeting with Sen. Orrin Hatch, R-Utah, who will become the ranking Republican on the Senate Finance Committee, taking over from Sen. Grassley, R-Iowa. We saw Fred Upton, a Republican congressman from Detroit, who could be the next chairman of the House Energy and Commerce Committee, and Paul Ryan, R-Wis., who is one of the great thought leaders on the Republican side in the House. We saw Eric Cantor, R-Va., who’s going to be the next majority leader in the House, and Republican Barry Jackson, who’s the chief of staff for soon-to-be Speaker John Boehner, R-Ohio.

DSN: What should pharmacy leaders look for from the new Congress?

Anderson: Bottom line, the regulatory process will continue with health reform, because the Republicans don’t have the votes at this point to repeal and replace it. You still have the Democrats in control in the Senate and the president, who can veto anything.

What that also means is that on any given day, you could have a healthcare bill on the floor of the House to do something, whether it’s to implement, repeal or replace health care. And that leaves all kinds of opportunities for pharmacy to be considered.

So there’s a lot going on, and I think we’re really well positioned because we’ve been out there with our message of pharmacy as the face of neighborhood health care.

DSN: Is there a sense that the new leadership will be supportive of that message?

Anderson: In meetings I’ve had, they seem very responsive to our message. Republicans thought we needed some type of healthcare bill, but I think most would have taken the incremental approach I talked about a couple of years ago, as opposed to the massive omnibus bill they ended up passing with all kinds of things in it.

The new Republicans in the House are looking for new solutions, and we think that pharmacy is at the center of those solutions. We have half as many doctors becoming primary care physicians as we did 10 years ago; we’ve got a store 5 miles from every home in the country and people coming out of pharmacy school with doctorates who want to do more than just dispense drugs. Bottom line, we have wrapped everything we want to do around this issue of medication adherence and medication therapy management.

The biggest issue we’re going to have with health care moving forward, both at the federal and state level, is that a vast part of the healthcare bill is going to get kicked down to the states. And there’s no money in state governments, and very little at the federal level. That will be the biggest challenge for anybody involved in health care. In changing the paradigm, we’re focusing on our adherence message. If you really want to drive down costs long term, MTM through pharmacies is one of those solutions.