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Pharmacy Outlook: Peter Matz, FMI – The Food Industry Association

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Pharmacy access has become even more important.

Peter Matz

Throughout the COVID-19 public health emergency, the importance of pharmacies to the health and well-being of the American public has never been more clear. Following the development and approval of COVID-19 vaccines early last year, pharmacies played an integral role in administering millions of vaccine doses to the American people to combat the spread of this infectious virus. As a result, the issue of pharmacy access has also become ever more important, with pharmacies continuing to face abusive practices from pharmaceutical middlemen that threaten their ability to keep their doors open at a time when Americans are turning more and more to their local pharmacies for vaccines, prescription medications and other products to support their overall health and well-being. Additionally, the concept of “food as medicine” has grown as more Americans turn to nutrition to help strengthen their immune systems and more broadly achieve their health goals.

Although most people understandably associate FMI – The Food Industry Association with the food value chain, pharmacy is of the utmost importance to our industry. With shoppers already trusting their primary grocery store as an ally in health, pharmacies are another way for food retailers to support consumers by enhancing the value proposition of total store wellness. FMI member companies operate roughly 12,000 supermarket pharmacies nationwide, with pharmacists providing a vast array of services, including in-depth patient counseling and comprehensive immunization services. They offer the ability for consumers to receive vaccinations at the same location where they already purchase food and other essentials, which is not only a convenience, it is safer and reduces the risk of exposure as COVID-19 continues to circulate among the population.

FMI worked tirelessly to help our pharmacy members prepare for a COVID-19 vaccination campaign, and with the availability of vaccines beginning early in 2021, FMI has continued to support their vaccination efforts while working closely with federal agencies and Congress to both elevate the critical role of supermarket pharmacies and advocate for our industry’s essential workers. We worked with the Department of Health and Human Services to clarify pharmacists’ role in administering COVID-19 vaccines and authorize them to do so regardless of state law; extend emergency authorizations to include pharmacy technicians and interns; and relax enforcement of signature logs, pharmacy audits and 90-day refills. Additionally, we worked to ensure that pharmacists were among the first to receive the vaccine, that supermarket pharmacies received increased vaccine allocations as well as ancillary equipment in government-provided pharmacy kits, and that pharmacies were fairly reimbursed for vaccine administrations.

To support food retail’s frontline hero pharmacy workers during this challenging time, FMI developed a resource guide to help members make plans to vaccinate their workers; a vaccine toolkit to help members promote grocery stores as health and well-being destinations; and signage for members to hang in their pharmacies to ensure the public knows that CDC guidance supports the coadministration of COVID-19 vaccines with other vaccines, including the flu shot, without regard to timing. We also worked to connect FMI supermarket pharmacy members with essential businesses that don’t operate pharmacies, so they could partner to host on-site vaccine clinics to provide COVID-19 shots to other frontline essential workers.

Beyond direct member assistance in relation to the pandemic, FMI has been committed to ensuring the financial strength of pharmacies so they can continue to offer much-needed products and services to their communities. Unfortunately, supermarket pharmacies are forced to contend with a range of abusive practices, including skyrocketing direct and indirect remuneration (DIR) fees and lowered reimbursement rates based on opaque methodologies, which severely harm the ability of supermarkets to maintain their pharmacies. We are continuing a full-court press advocacy effort to eliminate and prevent many of the anticompetitive practices that both increase consumers’ drug costs and threaten their access to supermarket pharmacies, including identifying and developing advocacy campaigns in support of state pharmacy benefits managers reform bills. We scored a recent victory when FMI-supported legislation was signed into law in Indiana to help patients and pharmacies alike, with other state efforts making progress.

On the federal level, FMI has long been working to eliminate the exorbitant, after-the-fact clawbacks known as retroactive DIR fees that PBMs charge to pharmacies without warning or market justification weeks or months after the pharmacy dispenses a drug to a patient. In recent months, FMI joined with pharmacy allies to tee up a new pharmacy DIR reform bill; hold a press conference highlighting a grassroots letter of support signed by 250 organizations; and participate in dozens of Hill meetings to advocate for the legislation. Those efforts have resulted in increased congressional support on a bipartisan basis for the new DIR bill, leading to a significant number of House and Senate cosponsors in a relatively short amount of time. FMI has also supported legislation directing the Federal Trade Commission to study and make policy recommendations about PBM anticompetitive practices. Additionally, we spearheaded the launch of the Coalition for PBM Reform, a diverse group that includes patient advocacy organizations and business/employer organizations in addition to pharmacy allies. By combining our collective and diverse voices behind the need to reform the anticompetitive behaviors of PBMs, we believe we have a powerful message to convey to policy makers that, without significant reforms, PBMs will continue to do business in a way that increases costs for patients, pharmacies and employers alike while simultaneously diminishing the level of care and access many patients need.

FMI has also worked to highlight the role supermarket pharmacies play in helping customers achieve their broader health goals beyond medications and vaccinations. For instance, data from our “2021 Report on Retailer Contributions to Health and Well-being” shows that food retailers are increasingly collaborating across departments to offer customers additional value and support. Specifically, 54% of pharmacists, dietitians and other health care providers developed programs together last year, up from 49% in 2019. Additionally, 60% of respondents indicated that pharmacy leadership is responsible for identifying opportunities to operationalize health and well-being strategies, notably up from 51% in 2019.

The pandemic has also demonstrated that Americans are increasingly looking toward nutrition to better align their diets with their health objectives. Last year, FMI made a concerted effort to highlight the importance of “food as medicine” as another tool in achieving positive health outcomes among the public. Data from our “The Food as Medicine Opportunity in Food Retail” report shows that registered dietitians/nutritionists and grocery stores/supermarkets are the top two sources cited by consumers for learning about “food as medicine.” Additionally, 80% of shoppers indicated that they found the concept appealing, and shoppers generally associate it with being healthy. To meet this growing interest among their customers, food retailers have developed food as medicine programs aimed at disease prevention and the promotion of health and well-being, management and treatment of disease, food and nutrition security, and food safety. They are implementing these programs in a number of ways, including nutrition education, food prescriptions, incentive programs and medically tailored nutrition.

Beyond what retailers are doing in-store to help customers meet their health needs, FMI has also focused on addressing food and nutrition insecurity with public, private and nonprofit stakeholders. We are especially proud of the fact that since the onset of the COVID-19 pandemic we have collaborated with federal, state and local governments to expand online redemption of Supplemental Nutrition Assistance Program (SNAP) benefits from five states in February 2020 to 46 states and Washington, D.C., as of this column. We also worked diligently with governments across the country on pandemic EBT programs to ensure families, and in particular children, were able to receive additional food assistance when schools and places of business closed down.

Last year, FMI also played a key role in the Bipartisan Policy Center’s Food and Nutrition Security Task Force, with FMI president and chief executive officer Leslie Sarasin serving as cochair. This group is charged with developing policy recommendations that improve access to food and nutrition for underserved communities in the United States. In September, the task force released its inaugural report examining food and nutrition insecurity in the era of COVID-19. Among the recommendations, the task force advised developing a standardized federal definition for “nutrition security” in consultation and collaboration with stakeholder groups; increasing the accessibility, availability, and intake of fruits and vegetables in all forms in federal feeding programs; and ensuring all individuals, especially those who are at disproportionate risk of food and nutrition insecurity, have equal access to affordable nutritious foods to promote health.

As the past year demonstrates, the food industry and its supermarket pharmacies are proactively engaged on a host of issues, from pharmacy policy to food and nutrition assistance, to meet the needs of the American people in achieving their desired health outcomes. As we enter 2022, we look forward to continuing to advocate for solutions that benefit our members, their communities and their customers.

Peter Matz is the director of Food and Health Policy at FMI – The Food Industry Association.


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