The importance of retail pharmacy has been thrown into relief by COVID-19, and the National Association of Chain Drug Stores is making the most of the present moment by informing members of Congress and other federal officials about policy matters that affect the profession and its ability to care for patients. The pandemic may have forced the 13th annual NACDS RxImpact Day on Capitol Hill earlier this month to be held virtually, but it heightened the force of the message that pharmacy advocates delivered during nearly 5,000 meetings with legislators, congressional staffers and members of the Biden administration.

Rick Keyes

“Today, we are dealing with what many believe are the most pressing issues ever to face our industry and the pharmacy profession,” said Rick Keyes, the association’s chairman and president and chief executive officer of Meijer Inc., during a webcast that kicked off RxImpact Day. “Among the issues we are facing, DIR fees, at the top of the list, threaten the viability of pharmacy, and they threaten the people we serve.

“At the same time, I also want to stress the opportunities. We need to continue to expand the ways that we can bring accessible health care to our communities as we have done on vaccinations and point-of-care testing, for example. We are committed to fighting and winning for the ultimate benefit of the patients we serve.”

Steven Anderson

Looking back at the first RxImpact Day in 2009, NACDS president and CEO Steve Anderson noted, “It was the beginning of the H1N1 pandemic, and pharmacies would go on to prove their value in new and powerful ways; certainly by emerging as trusted and efficient vaccinators. Now, here we are 12 years later, and once again we have an extremely powerful case to make to the government. Just look what pharmacies and their dedicated teams can accomplish for the American people, and just imagine what more we can do if given the opportunity in public policy.”

During the COVID emergency, the profession has had a chance to demonstrate what it can do to promote the health and well-being of Americans. With stores located within five miles of 90% of the U.S. population, pharmacy is deeply embedded in the community. The resulting ease of access, together with the high level of trust that pharmacists command among patients and caregivers, put members of the profession in an ideal position to support public health. Pharmacy operators were quick to get involved in coronavirus testing last spring, and they are now ramping up to deliver more than 100 million COVID immunizations per month, once they have access to enough vaccines.

The 327 participants in RxImpact Day — from schools of pharmacy and state pharmacy associations as well as NACDS member companies — lobbied for extension of the expanded powers granted to the profession under the Public Readiness and Emergency Preparedness Act and the Federal Retail Pharmacy Program. They argued that locking in those authorities until at least 2026 would help the U.S. work through the pandemic more efficiently and effectively, relieve the burden on other health care providers, and leave the country better prepared to cope with the next public health crisis.

Pharmacy advocates continued their assault on direct and indirect remuneration, a practice under Medicare Part D that allows PBMs to use often ill-defined and inconsistently applied quality measures to claw back a portion of payments. DIR fees threaten the viability of many pharmacies and, therefore, access to care, as well as driving up out-of-pocket drug costs for seniors. The uncertainty surrounding the fees and their adverse financial impact played a large part in the demise of thousands of pharmacies in recent years, and have sown widespread concern about how long many others, particularly independents, can hold on.

In one form or another, scope of practice and remuneration have received a lot of attention since RxImpact Day’s inception. The final item on the priority list for 2021 reflects the changing nature of business in the digital age. Legislators were asked to cosponsor and support the Integrity, Notification and Fairness in Online Retail Marketplaces for Consumers Act. Pharmacy advocates told members of Congress that the measure is needed to protect shoppers from purchasing stolen or counterfeit merchandise through the internet. The Inform Act would require online marketplace operators to do a better job of supervising the sellers they work with. The hope is that greater oversight will not only protect consumers but lead to a reduction in organized crime against brick-and-mortar retailers and other businesses.

NACDS RxImpact Day left legislators and other officials with a lot to think about in terms of specific policy questions. Equally important, the interaction between policy makers and pharmacy advocates from across the county enriched and deepened a dialogue that has gone on for more than a decade, a conversation that has already done much to raise the stature of the profession.