Cameras like politicians; politicians like cameras. If you can get in the middle of the love affair, you may just get noticed.
At least that’s what some local business owners are hoping.
A grassroots movement of Connecticut pharmacy owners, headed by Bob Bradley, owner of Beacon Falls Pharmacy on North Main Street, is trying to use the upcoming elections as a platform to voice its stance on a growing issue in the pharmaceutical field.
In the coming months, the group of roughly 25 pharmacy owners spread across the state hopes to gain publicity by sending petitions to elected officials and candidates, attending political fundraisers, bringing political figures to monthly meetings, distributing leaflets and holding press conferences among other techniques. Their main rallying point is a federal bill, the PBM Audit Reform and Transparency Act of 2010 (H.R. 5234), which, they hope, could stop the bleeding of customers and money most small pharmacies have experienced due to the growth of large pharmacy benefit managers, or PBMs.
“We need to get our voice out there about H.R. 5234,” Bradley said. “We’re at a time right now where these candidates have a lot of opportunities to make their positions known. We need to get through to the candidates and bring a light to our message.”
The group’s message—and the aim of the bill—is to give prescription drug users a voice in where and how they obtain their medication. They believe no person should be forced to attain their prescriptions via mail-order pharmacies, and that they should have the right to go through their local pharmacy.
“All we want is for customers to have a choice,” said Margherita Giuliano, Executive Vice President of the Connecticut Pharmacists Association. “Some people want to use mail-order, but some may want to go to their local pharmacy and it’s wrong to not allow them to have that choice.”
The bill, if approved, would limit ownership conflicts of interest and require greater disclosure among patients and plan sponsors. Additionally, and possibly most importantly, it would no longer allow companies to mandate that beneficiaries use a specific pharmacy (retail, mail, or specialty) if the pharmacy benefit manager has an ownership interest in that pharmacy. The bill would also prohibit offering incentives to encourage patients to use only the PBM-owned pharmacy.
According to a Connecticut law residents are already supposed to have the right to get their medications wherever they want. That law (C.G.S. Sec. 38a-544) reads, “No medical benefits contract on a group basis, whether issued by an insurance company, a hospital service corporation, a medical service corporation or a health care center, which provides coverage for prescription drugs may require any person covered under such contract to obtain prescription drugs from a mail order pharmacy as a condition of obtaining benefits for such drugs.”
Still, several large area employers, such as Sikorsky, IBM and Northeast Utilities, require beneficiaries to order prescription drugs from mail-order companies, taking away the option of getting medications from their local pharmacies.
The companies can get around the law by self-insuring rather than contracting with an insurance carrier like Anthem Blue Cross Blue Shield or Cigna. This allows them to compel employees to perform all transactions through mail-order companies such as RegenceRx, Caremark or Express Scripts.
This trend is taking money and customers away from local pharmacies and putting them into the pockets of large, mail-order companies, or PBM’s.
“Everyone is losing money but the PBMs,” Bradley said. “Their profits are going up astronomically; in turn, though, it’s causing premiums to go up and doctors and pharmacies to get squeezed. It’s also funneling jobs and revenue right out of state. We’re at a time where we need to create more jobs, and we’re ready to, but all this is doing is taking them away.”
The reason conglomerates are choosing to make the switch to mail-order is strictly financial. Big businesses appear to save large amounts of money by pushing all employees towards mail-in.
The small businesses disagree. They say it appears to be cheaper, but when you look at the entire transaction it may not be.
“I’m not so sure they aren’t charging more on the back end to make up for the inexpensive premiums on the front end,” Bradley said. “It certainly isn’t as set in stone as people think.”
Guiliano echoed Bradley’s sentiments, saying the reason it looks so good is because some things are hidden.
“They’re only opening one side of their books,” said Giuliano. “You can’t see everything else that goes on after the initial costs.”
The argument is still being deliberated around the country, but more and more businesses are starting to make the switch. For this reason the group feels now is the time to inform the public of what is happening and educate those who would be affected by HR5234. Leaflets with statements reading, “Tell your U.S. Senator and Representative to support bill No. H.R. 5234”, “I want to choose my own pharmacist like I would choose my own doctor”, “I don’t want to be forced into a mail order situation” and “I want my family and I to have face-to-face interaction with our pharmacist” have been given out in pharmacies across the state.
Thousands of signatures have been collected for a petition in favor of the bill which will soon be sent to officials holding and running for the positions of governor, assistant governor, senate and comptroller as well as current U.S. Senators Chris Dodd (D) and Joseph Lieberman (I) and U.S. Representative Christopher Murphy (D-5th District).
The group is also hoping to get politicians to their meetings, where they can inform the candidates of the current state of pharmacies and the potential impact of the bill, which is currently under subcommittee review.
“If we could get the ear of some of these candidates, that could change things,” Bradley said. “If we could get them in here and just talk to them about this, it would be huge.”
The group also desires a press conference with a candidate discussing the H.R. 5234, preferably in a state pharmacy.
“If we could get these candidates into the pharmacies and address this, I think it could make a big difference,” Giuliano said.
The group is continually trying to find ways to make its voice heard, because their voice, although it may have only a small impact on this bill, could have a large impact on pharmacists’ fates.