Magazine October 2019

Pharmacists Prescribe Access, Economic Impact in Arkansas


Gov. Asa Hutchinson

by Tristan Bennett

Pharmacists often are the most accessible health-care professionals in Arkansas, especially in rural parts of the state. The Arkansas Pharmacists Association (APA) bands together 2,500 pharmacists to help establish the future of the profession while still protecting the patient. 

Pharmacy is a large industry in Arkansas that touches virtually every resident. Every segment of health care such as hospitals, nursing homes, rehab facilities, insurance companies, government agencies and more rely on pharmacies to provide patients with important prescriptions. 

“Pharmacists are medication experts, the most accessible health-care professionals and fulfill roles as counselors, protectors, advisers, patient advocates and friendly faces,” says Jordan Foster, APA director of communication. The industry also provides more than 10,000 jobs and facilitates $3.9 billion in retail sales in the state. 

APA members have the opportunity to keep connected to their profession. The association offers access to continuing pharmacy education hours, a requirement for a state license, has experienced staff pharmacists who are available to answer questions and gives its members a voice at the state capitol. 

Arkansas pharmacists saw a tremendous amount of success in the past two legislative sessions. In 2018, legislation passed that required pharmacy benefit managers (PBMs), third-party administrators of prescription drug programs for health plans, to be licensed by the state and forbids PBMs from paying their pharmacies more than independent pharmacies for the same prescription, according to Foster. 

This year, APA advocated for legislation that would clarify those regulations and enforcement authority. 

“Much like last year’s bills, the 2019 legislation, a comprehensive bill intended to strengthen the PBM Licensure Act of 2018, was incredibly popular among lawmakers after they heard testimony from pharmacists and APA staff,” says Foster. 

The new legislation sets a payment floor for ingredient cost payments, addresses spread pricing and requires PBMs to report rebates every quarter. 

This groundbreaking legislation has benefitted the pharmacy industry, but APA still faces problems. Fees, rebates and price adjustments — secretly charged retroactively — are putting many pharmacies in financial jeopardy.

Foster says, “Often a pharmacy could think it has made a profit on a prescription at the point of sale, but then much later discover that, due to DIR [direct and indirect remuneration] fees, the profit was much smaller than anticipated or even non-existent.”

Pharmacists are not able to plan for these fees as they make staffing decisions and pay bills, often making it hard for independent pharmacies to stay open.

Foster does not see DIR fees being eliminated in the near future and says the fight will continue. “However,” he says, “pharmacists will always put the patient first, advocating for the health and wellness of all Arkansans and remaining one of the most trusted professions in America.” 

APA will continue to represent its members at the state capitol, state board of pharmacy and Arkansas Medicaid offices to champion for patients, taxpayers and the pharmacy profession, he says.

The Association Roundup is a monthly feature that takes a look at the issues affecting Arkansas’ professional industry associations.

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