Helping save community pharmacies

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In recent years, the burdens of operating a small community pharmacy have grown. We have seen this play out across the country, as many established, small business pharmacies that have served their communities faithfully for decades have been forced to shutter their doors.

In fact, from 2003 to 2018, more than 1,200 of the nation’s 7,624 independent, rural pharmacies closed— jeopardizing access to reliable, quality care for millions of patients across the country and throughout Maryland.
As the 2022 Maryland General Assembly session continues, the strength of our small pharmacy community continues to be vulnerable, and lawmakers must seek legislative proposals that protect community pharmacies and those that support their livelihood

specifically, I urge the Legislature to amend Chapter 399, Maryland Acts of 2020 by passing Senate Bill 823 and House Bill 973 to properly reflect the role of essential pharmacy partners known as Pharmacy Services Administrative Organizations (PSAOs).

Complex system

There are several factors pressuring our community pharmacies, and they are complex and multi-layered. The health care system is undoubtedly complicated and managing relationships with insurers and pharmacy benefit managers (PBMs) is both incredibly challenging yet entirely necessary. For example, pharmacies must sign and manage many different contracts and jump through all sorts of hoops just to dispense medications for their patients and ensure that insurers will cover patient prescriptions.

For large chain pharmacies, dealing with this red tape is not as much of a problem. With the corporate structures and large, specialized staff, they have the capacity to negotiate directly with PBMs and remain competitive.

On the other hand, small independent pharmacies struggle to manage these relationships and run a business at the same time. While community pharmacies excel at offering quality care and helping their patients, we are also small business owners and the intricacies of claims, contracts, reimbursements, compliance and credentialing only take us away from the pharmacy counter and our patients.

Fortunately, PSAOs exist to advocate for community pharmacists and help alleviate the operational and administrative burdens caused by our health plan-controlled system. By managing complex administrative tasks on behalf of small, local pharmacies, PSAOs help to keep our doors open and do what is most important: serve patients and our community members.

Drug prices

It is no secret that small pharmacies have seen increased pressures over the last two years. In the era of COVID-19, our role grew as we provided testing, vaccines, boosters and information to Americans on top of our regular responsibilities. Pharmacies were busier than ever and even short-staffed in many instances.

But our PSAOs were by our side every step of the way, helping us navigate and understand the contract amendments to adapt to the pandemic, including acquiring vital vaccine doses and providing curbside pick-up and delivery services to people in our communities.

A PSAO’s job is — and will always be — to help pharmacies address operational and administrative challenges. Speaking from experience, PSAOs do not influence the price of medication or drug benefits. Thus, regulating PSAOs like a PBM and treating these two entities as if they are the same will not result in the prescription drug transparency that lawmakers are seeking.

For PSAOs, supporting small, independent pharmacies and helping Americans stay healthy are top priorities. As more and more small pharmacies feel the pressures of a complicated health care system and COVID-19, PSAOs are more important than ever in helping community pharmacies stay open for business.

I urge lawmakers to correct the confusion created by Chapter 399, Maryland Acts of 2020 and pass SB 823 and HB 973. Maryland’s community pharmacists and our patients are counting on it.

Christine Lee Wilson is the owner of Professional Pharmacy in Rosedale.