pharm 2SACRAMENTO, Ky. (2/17/18) — Some independent pharmacists in Kentucky believe an effort is being made to push them out of business. Now, these independent pharmacists are fighting back.

Several independent pharmacy owners rallied community support at a meeting at Sacramento Elementary School this week. Those attending included Sacramento Mayor Betty Howard, local pharmacist Dr. Gregg Henry and Kentucky Independent Pharmacist Alliance board member Dr. Brad Ashby.

KIBA, a 500-member organization, is comprised of independent pharmacists including Henry and Ashby.

At the meeting, pharmacists presented copies of their daily profit/loss statements and publications supporting their positions including an article from THE AMERICAN PROSPECT breaking down how independent pharmacists are subject to predatory reimbursement activities. They believe the large pharmaceutical companies are moving to consolidate control of the industry.

The article in THE AMERICAN PROSPECT makes allegations of questionable practices involving federal and state government and CVS Caremark. CVS Caremark operates more than 9,000 pharmacies and is a pharmacy benefit manager, which sets the rate that competing independent pharmacies are reimbursed for certain prescriptions for Medicaid patients.

PBMs operate under contract with state or federal governments to administer the distribution of prescription benefits to Medicaid patients. The independent pharmacies claim that Caremark is engaged in unfair competition by giving independent pharmacies arbitrary and capricious reimbursement rates without oversight or transparency.

The independent pharmacists in attendance agreed that something had to be done or communities would be losing their local pharmacies.

Henry said that the four pharmacies represented at the meeting may receive different reimbursement rates for the exact same prescriptions and that Caremark often changes reimbursement rates several times per day.

The pharmacies claim that the reimbursement rates set by Caremark and other PBMs are often below their costs and well below the rate set by Federal Medicaid.

Furthermore, with diminished profitability, the independent pharmacies are receiving offers to buy their pharmacies — from the same company that has slashed their reimbursements, devaluing their businesses, they claim.

pharm 1Practices like those alleged by the pharmacists have led to current anti-trust laws in the United States.

Now, the independents are fighting back with legislation to level the playing field — Senate Bill 5, which would give control back to the state for the pharmacy benefits part of the Medicaid program.

Henry, who owns Sacramento Pharmacy, noted that independent pharmacies give back to their communities.

“For the first time in five years, I’ve had to say, ‘No,’ to sponsoring groups in our community,” said Henry. “Just before the meeting, I was asked to help a local basketball team and had to explain why we couldn’t help this year. We are struggling to keep the doors open.”

He said that he had received an offer to buy his pharmacy.

“If they buy my store, do you think they will open a store in Sacramento with a population of 1,000?” he asked.

Henry said he is not selling and will fight on.

SB5 has passed out of committee in the state Senate and is awaiting full Senate approval. If approved, it will move to the House for committee approval and full vote of the House, then, Gov. Matt Bevin would have to sign into law.

Ashby said that the bill is being vigorously opposed by big PBMs.

“They are using lobbyists to wage the fight and we are informing the public,” said Ashby.

Approximately 50 people gathered in the gym and heard pleas to call Frankfort and voice their support for SB5.

Henry is asking people to call the legislative message line at 1-800-372-7181 to send a message to senators and representatives asking them to support SB5.

pharm 3

Ron Sanders
SurfKY News

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