Lessons from the Playground | NCPA Executive Update | May 10, 2019

NCPA May 9, 2019

Dear Colleague,

Doug Hoey

Its graduation season and millions of students are walking across stages to receive their diploma which signifies years of classroom learning. No diplomas will be issued for some of the lessons learned on school playgrounds, but they can have equal importance.

I learned a lifelong lesson many years ago on one of those playgrounds. I was playing a friend/rival in a one on one game of basketball. It was one of those games where the hoop seemed to me like it was big as a clothes basket and everything I put up was going in. I don't remember the exact score, but I think I was up 11-zip on my opponent playing to 15. This is where the life lesson comes into play.

I let up. I started to sluff off. Allowed a lay-up here; an uncontested shot there. I had the momentum and willingly gave it up. For no reason. I wasn't tired. I was having fun. But, I didn't finish the game.

You can probably guess what happened. The same shots that were falling effortlessly started to clang against the rim. A favorable roll or bounce here and there started going the other way. And...my opponent came back and won. I don't remember the exact score...16-14; maybe 17-15 (had to win by two points) but it was a game I should have won and 35 years later it's a lesson I haven't forgotten.

Community pharmacy has a lot of momentum on its side right now. Momentum we have not seen in a long time. Look at the proposed rules that CMS has issued that would end retroactive pharmacy DIR fees as an example. Look at the President signing legislation to prohibit pharmacy gag clauses. Or, look at the examples in many states of the exposure of PBM's increasing taxpayer costs in Medicaid Managed Care programs, the model PBM regulations passed by the National Council of Insurance Legislators (NCOIL) that has been helpful in spurring increasingly effective PBM legislation and oversight in state capitals across the country.

There is a temptation to say, "Well done," and let up our guard. That would be a big mistake.

There is still much more to be done. What should be a bonafide, balanced business relationship between PBMs and community pharmacies is still a one-sided affair with take-it-or-leave it contracts that are adjusted or amended whenever the PBM sees fit. Changing the pharmacy payment model is still critical and much more work is needed.

It's taken years of advocacy led by NCPA, but most members of Congress now know what a PBM is and the impact they are having on community pharmacies and the patients we serve. The President is focused on lowering prescription drug prices, which means there are plenty of opportunities for community pharmacy to weigh in with solutions and ideas for payment models better than what we have today. As a small businessperson and your community's most accessible health care professional, you're perfectly positioned to brief them on the real, everyday impact of our key legislative initiatives, to lobby for your business and you patients.

Does anyone think for a moment that our opponents aren't doing everything in their power to kill our momentum? They are used to ruling the playground and okay with bullying by whatever means to reach the ends they promised shareholders. Staying focused on the legislative priorities of changing the pharmacy payment model, starting with eliminating pharmacy DIR fees and moving toward a true business relationship, are essential in keeping the momentum we have built.

We're coming up on Memorial Day, or as it is known in Washington, another congressional recess. Members of Congress will return to their home districts May 25-June 2, and there's never been a better time to extend an invitation to your representatives to visit your pharmacy.

If you're not sure how to get started, take the first step today. NCPA can guide your through the process and ensure that your visit is a successful one. Take a look at NCPA's pharmacy visits webpage or email Michael Rule for tips on arranging a visit.

Lessons on the playground should not be lost. Momentum is important. We have it right now. Schedule a pharmacy visit. Keep reaching out to state and local legislators. Let's end this game on top.


Doug Hoey