Advocacy Event

Ohio Pharmacists Association

Student Legislative Day

Representative Merrin Speaking

This is a great event to attend and is extremely informative while also giving you a chance to make a difference in policy. I chose to attend OPA’s Student Legislative Day, because OPA lays out a great format to provide you a platform to get in front of a state representative or senator and have a conversation. This opportunity is unique and also helps you grow as a person. During this event, I began to realize how imperative it is to take a stance somewhere within our profession and educate our legislators about the climate of pharmacy. Things aren’t always perfect in our profession and we should always be striving towards bettering our profession and environment that we work in. Not only for pharmacists and the people we work with, but also for the betterment of our patients. This event gave pharmacy students and pharmacists a great platform to express our views and speak to our state legislators.

By speaking to and persuading our legislators, we can change the law in order to better our profession and our patients.  This may sound like a large objective in its entirety, but if we break it up into smaller tasks (even though today seemed like large one) then over time we can change the climate and the view of our profession.  This starts with purely providing education on what we do. Many people do not know what a pharmacist truly does or provides to the public. Being able to go into a legislators office and speak to a story that we have had with a patient is huge. It sets the tone for how the profession provides for the public and also shows why our opinion matters. If we are unable to have resources to perform in our profession, it can take away from the public’s access to healthcare.

Friends on the Steps of the Statehouse

These are some points that we brought up to Charleta Tavares, our state senator, and Kristin Boggs, our state representative. A group of student pharmacists were able to go into each meeting and speak to the different experiences that we had and make an impact on Senator Tavares and Representative Boggs’ opinions. This seemed rather intimidating at first, however, when you think about it we are part of their constituents. They should want to hear what we have to say and take it into their own consideration. Having this thought in the back of our minds put nervousness at ease and allowed for a productive conversation between all involved. We spoke about the different bills that are in the House and Senate right now and how they would effect pharmacy. Senator Tavares and the aide for Representative Boggs (Representative Bogg’s had to miss our meeting for another commitment) were both very open to hearing what we had to say and using our conversations as educational points for each other.

It was a great interaction.I think that the main thing to take away from OPA’s Student Legislative Day, is that advocating for yourself, your profession, and our public is important. It may seem intimidating at first, but when you realize you are there to try to push the greater good, then it becomes an agenda that you can truly speak to. People are nice and most truly do want to help to make things better for the public as a whole. Putting yourself out there as an advocate helps build yourself personally and professionally and this event truly set you up for success. I’d like to thank OPA and everyone who helped put Student Legislative Day on. It was a success and truly a good time. If you would like to learn more, a link to a description of Student Legislative Day is posted below.





Hot Topics Discussion

Mandatory Counseling? Debate and Discussion. Pharmacist providing counseling to father with sick child

This past week, my pharmacy advocacy class had a great discussion on the topic of mandatory counseling. This subject has been brought about by recent changes in legislation in other states in the country that require by law that pharmacists counsel on every new prescription. This has both good and bad connotations to it. We went into great depth and detail about the pros and cons of a law that forces mandatory counseling into practice. Although I don’t think that many of us were convinced either 0ne way or another, I do believe that the discussion we had was extremely productive and enlightening.

After doing some research of my own prior to class, I was convinced that mandatory counseling inside a busy community pharmacy was doing the profession a disservice. I thought that legislation like this would steal autonomy away from pharmacists and just create another hoop to jump through during a busy day. The current atmosphere in most community pharmacies isn’t conducive to interruption-free work which can make processing prescriptions dangerous if too much is going on around the pharmacy. In my mind, before class, adding in mandatory counseling would just add to these interruptions and take away from the pharmacist’s ability to evaluate what is truly important. During the discussion, however, my opinion on this began to morph into more of a grey area that I wasn’t expecting.

Big points for

  • this would help to protect the pharmacist’s role
  • it would increase contact time with the patient
  • we would be able to cut down on adverse drug reactions and errors

Big points against

  • increased interruptions for the pharmacy team
  • takes autonomy away from the pharmacy team
  • trying to counsel on “new” prescriptions that are just refills (somewhat redundant)
  • patients may have to wait for the pharmacist to have to time complete required counseling

Interesting points and questions

  • How would this affect hospital pharmacists?
  • If we keep on stretching our pharmacy teams so thin, at what point are we making unethical decisions?
  • Could this bring up more clinical opportunities for pharmacists?
  • Would this force community pharmacies to begin shifting their resources less towards dispensing and more towards clinical roles as we stretch our time even further?
  • Where does reimbursement for time come into play?

busy community pharmacy

All of these points mentioned essentially brought the class to one conclusion. The answer to mandatory counseling isn’t black and white whatsoever. It is much more grey than any of us expected. My viewpoint definitely changed throughout our discussion. I think that mandatory counseling could play a role in the profession, but it needs to be set up in a way that is beneficial and not redundant for the pharmacy team. In my eyes, I think that every new therapy and therapy change should be counseled on. In my experience, this is what many pharmacists do already. The mandatory counseling idea could be used to reinforce counseling on new therapies and therapy changes.

The forum discussion that we had in class was very beneficial for tearing the details of this topic apart. Providing pros, cons, and questions of concern was a great way to insert detail into the discussion. People saw things pop up that they weren’t thinking of and were then forced to address it from their viewpoint. This discussion process helped to have a productive and non-biased conversation about an important new topic.

If you would like to learn more about why mandatory counseling is becoming a hot topic, follow these links. The first one is a pharmacist advocating for mandatory counseling. The second link is to a discussion thread with pharmacists talking about first-hand negative and positive experiences with this type of legislation in other states. Enjoy and become more informed!

Pharmacy in the Media

The Clawback – How Will We Claw Back?

The LA Times recently posted an article on a hot topic across the country that elaborates on a possible reason behind rising drug prices. The article covers a topic called clawbacks. Clawbacks occur when a PBM (pharmacy benefit manager – the middleman between pharmacies, insurers, and drug manufacturers) is able to take some of the money that is paid to a pharmacy by the insurer as their own. The PBM is able to make money off of clawbacks through negotiating prices with all parties mentioned above. They take a portion of money from the claim that the pharmacy and the patient will never see.

Now that we have introduced the topic, let’s talk about why this is a bad look for all involved in pharmacy. People don’t understand the exact operations that go on behind the counters of a busy community pharmacy. This article that the LA Times wrote, talks about the large money flow that crosses between pharmacies, insurance companies, PBMs, and drug manufacturers. Unfortunately, from the sound of it, PBMs have unfairly used their platform to negotiate private contracts that benefit them to make more money that none of the other parties see. As you can imagine, with rising drug prices and healthcare being such a popular topic in the news, it isn’t a good look for anyone involved. Prices are being inflated for someone other than the patient to gain money.

How are prices being inflated? Well, PBMs have managed to negotiate prices with insurers that are actually over the cash price of certain medications. A percentage of the difference is then sometimes rewarded to the PBM through this thing called a clawback. So, basically, the price of a medication is being inflated, in order for a PBM to profit. The middleman gaining more money. Then there are things called gag clauses in some contracts that keep pharmacies from speaking about the lower cash price. This sounds pretty bad and obviously, the public should be mad. Now, put the gag clauses to the side. This article makes pharmacists look bad by basically saying that we hold our tongues to essentially not get in trouble and lose contracts from insurance companies. I disagree. Pharmacies fill hundreds of prescriptions a day. If a technician or pharmacist had to bill insurance and then bill cash for every single prescription to see which one was cheaper, that would double up the load at one of the workflow steps. This is extremely tedious and goes against the grain of efficiency that every pharmacy strives for to survive right now. Pharmacies don’t try to harm patients by billing whatever costs the most. Most technicians and pharmacists that I know go out of their way to try to make scripts cheaper for their patients.

Parts of this article are pretty community pharmacy negative. The article makes it sound like pharmacists have their hands tied behind their back and can’t do anything to benefit the patient. The LA Times, in my opinion, needs more education on the workflow that goes on behind a pharmacy to truly understand how the idea of a clawback becomes a problem for not just the patient, but also the pharmacist and technician working to fill their prescription. Generally, the technician that gives the patient the script is the last person there to tell them the price. That means that the technician becomes the butt-end of the patient’s financial problems with their prescription. Not a good problem to have.

This article portrays a negative intention on the entire process of filling a prescription. It’s unfortunate. It paints PBMs as the culprit, but then it makes other pieces of the pharmacy puzzle out to be helpless. I chose this article because it is a hot issue and everyone could be more educated about it. It is a somewhat complicated idea. I think this could have been spun as community pharmacy positive if the LA Times decided to focus more on how pharmacists try to make things cost-effective for their patients using some type of anecdote. The main thing to take from this though, is how will we claw back and fight this practice?


What is Pharmacy?

Accessible. Expanding. Busy. Medication Expertise. Problem Solving.

Pharmacy is a very diverse field that is constantly trying to address new problems successfully. Healthcare is ever evolving and this causes pharmacy to evolve right along with it. Pharmacists adjust their workflow activities and the tasks they focus on in order to better address the public problems that are presented to them. Pharmacists practice over a wide range of careers from poison control, to consultants in the hospital, to the management of PBMs, to your neighborhood community pharmacist, and many more. Pharmacists are problem solvers and that is the number one job that they hold.

This unique range of skills that pharmacists hold allows them to be utilized by the public as a medication expert. Our healthcare field is constantly trying to manufacture new therapies using medications so this keeps pharmacists on a continual treadmill of education. Constantly consuming data to learn about new therapies and stay up to date on old ones.

These unique traits put the field of pharmacy at a strong vantage point to help cover the gaps that are currently in our healthcare field. Many people out there still don’t have great access to healthcare. Pharmacists are one of the most accessible professionals available to provide healthcare. They are a phone call away and most pharmacies don’t require an appointment to see their pharmacist. What other setting do you know where you can walk in and get a vaccine and a consultation without an appointment and possibly be in and out in 20 minutes?

There are many success stories in pharmacy. This link below talks about some of them at this cool and unique website. Pharmacy Home Project does a great job showing off some of the great things that can happen in patient care with a pharmacist present. One of these stories speaks about how a chronic pain patient was having quite a lot of trouble with constipation. The patient, very innervated by their problem, did not know how to handle the situation. The pharmacist happened to dig a little deeper into the situation and found out that the patient was never prescribed or educated on the fact that the pain medications the patient was taking could cause constipation. The pharmacist then stepped in and advised that the patient begin taking a laxative and stool softener combination therapy. This solved the patient’s problem and allowed them to get back to life without having to worry about this unnerving problem. The pharmacist was able to provide the patient some education, advise, and lead them back to peace of mind. They possibly even prevented a physician visit or emergency room charge.

Pharmacy is truly many different things, but these are a few things that I believe pharmacy exemplifies. Pharmacy is poised to be a huge player to cover gaps in care for our public’s healthcare problems in the coming years. Creating transparency and educational points to show what pharmacists can do for people is huge, that way we can continue to provide great care for everyone. Pharmacists. Problem-solvers. Caregivers. Medication consultants.