Industry poised for ‘historic paradigm change,’ NACDS chief Anderson tells pharmacy leaders

SAN DIEGO Retail pharmacy is going through a “historic paradigm change” as pharmacists and pharmacy leaders expand their patient-care and clinical capabilities and provide new solutions to a “broken” healthcare system undergoing rapid change. 

That was the message delivered Monday by Steve Anderson, president and CEO of the National Association of Chain Drug Stores, on day two of the 2010 NACDS Pharmacy and Technology Conference. Buoyed by a series of legislative and policy-making victories –– and by the growing recognition from public and private health plan payers of the role pharmacists can play in improving patient outcomes and lowering health spending –– the pharmacy industry is poised for a “renaissance” in how pharmacy is practiced and how pharmacists collaborate with other healthcare professions, Anderson told NACDS members.

Much remains unfinished, he warned. “We need to build a case for a modern and viable reimbursement system” that takes into account pharmacy’s contributions to health and cost-effectiveness, the organization chief noted.

To that end, Anderson on Monday announced the launch of a new component of the bipartisan grassroots lobbying campaign, dubbed RxIMPACT Votes! “This is what political professionals refer to as a get-out-the-vote campaign,” he explained. “It encourages NACDS member company staff to register to vote, encourages them to volunteer for political campaigns of their choosing and then inspires them to vote on election day. This is a bipartisan program,” Anderson added, “and we will not be so bold as to tell anyone in pharmacy for whom they should vote. But we will explain why they need to vote.” 

Anderson doesn’t take personal credit, but much has been accomplished at NACDS and within the pharmacy industry since he began his watch as the organization’s spearhead in February 2007. He urged attendees to “think about the transformation of NACDS that we have discussed here since 2007: the creation of new and results-focused departments at NACDS in communications and in government affairs; telling the story of pharmacy as ‘the face of neighborhood health care;’ building our grassroots advocacy network, RxIMPACT; [and] elevating the NACDS political action committee, which supports pro-pharmacy Congressional candidates.”

The list also included “earning victories on legislation and regulations; advancing the NACDS Principles of Healthcare Reform; [and] collaborating with the National Community Pharmacists Association, state associations and other partners –– all while maintaining a compulsive focus on member-service and value,” Anderson said.

Nevertheless, Anderson reminded listeners, the pharmacy profession continues to fight a century-old battle to overcome old and highly damaging misperceptions and stereotypes. A big source of those misperceptions: the infamous and highly influential Flexner report, issued 100 years ago under the title, "Medical Education in the United States and Canada –– A Report to the Carnegie Foundation for the Advancement of Teaching."

“This year ... marks the 100th anniversary of Abraham Flexner’s work,” said NACDS’ CEO. “The Flexner report, issued in 1910 ... is credited with reforming medical education. But that era is blamed for kicking pharmacy into the ditch, lumping pharmacy with what some call nonscientific disciplines, like acupuncture, naturopathy, homeopathy and chiropractic. That was 100 years ago. And we are still fighting back,” Anderson added.

“Standing before you and saying that pharmacy has achieved its rightful place in health care would be crazy,” he went on. “We are not there yet. But we have gained tremendous ground –– and at a solid clip.” Indeed, Anderson added, “While much work remains, I am confident in describing these times as a time of pharmacy renaissance. This renaissance refers to advancements of NACDS members in patient care. It also refers to recognition of this work by policy-makers, opinion leaders, the media and other healthcare providers.”

That recognition is reflected in the language contained in the mammoth, 906-page health-reform bill enacted earlier this year. The new law, Anderson said, contains “ninefold more references to pharmacy” than the Flexner report that lay the course for health care in America over the next century, “plus 19 references to pharmacists and even 10 to medication therapy management.”

Through intensive lobbying and grassroots efforts, NACDS and its members succeeded in getting many pharmacy-friendly provisions in the health-reform act. One message that was particularly effective in reaching lawmakers crafting the bill in Washington, the organization CEO said, was the key role community pharmacists can play in improving the dismal rate of medication adherence through pharmacist interventions with patients.

“Everywhere we turned, we told decision-makers about the $290 billion in annual costs that are related to poor adherence, as estimated by the New England Healthcare Institute,” Anderson said. “That’s important to understanding the value of medications, and those who help patients manage them.”

The fruit of those lobbying efforts is a health-reform overhaul that recognizes the role of pharmacy in an integrated, patient-centered, outcomes-oriented healthcare system. “Here is what we achieved,” NACDS’ leader told his audience. “Take medication therapy management; the new healthcare law includes grant and pilot programs that include MTM, and it improves the Medicare Part D MTM benefit. We have studies in which every $1 spent on MTM reduced overall health spending by $12. Members of Congress wanted to put this into action.”

Anderson also cited the progress of efforts to find “a remedy to the crushing pharmacy cuts under the Medicaid average manufacturer price model.” The new health-reform law, he reminded listeners, “says that federal upper limits [for Medicaid prescription reimbursements] will be set using a multiplier of ‘no less than’ 175%. That leaves some leeway for the Centers for Medicare and Medicaid Services, and we will need to remain vigilant as this law is implemented.”