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The Yin and Yang of Pharmacy

Harold E. Cohen, RPh
Editor-in-Chief



10/18/2013

US Pharm. 2013;38(10):1.

It is no great secret that retail pharmacy has been grappling with its identity for decades. Many chain and independent pharmacy owners continue to struggle financially because of a health care system that does not justly reimburse them or their pharmacists for the professional services they provide. And many politicians persist in treating pharmacists as expendable laborers and the drugs they dispense as common household commodities. Just when I thought the yin and yang of pharmacy—business versus profession—was finally tilting to the professional side, come two announcements in the past month that could signal a setback for the future of retail pharmacy. While either announcement by itself will not have an immediate impact on pharmacy, it is the tone they are setting that has me concerned.

For years, a strong regional pharmacy chain of 78 stores in North Carolina was synonymous with patient care and stood as a model of the professionalism that could be accomplished by a chain pharmacy while continuing to run a successful business. While it had all the components and departments of much larger national chains, Kerr Drug was most notable for the way its pharmacists practiced the profession. So when it was announced that Walgreens had purchased the chain, I felt a twinge of sadness that another regional chain whose professional principles would not be compromised would soon be gone. What set Kerr Drug apart from other drug chains was Anthony Civello, Kerr’s president and CEO, who shaped the chain into what it is today. In a recent interview, he said the key was his devotion to the core principle of “providing patients access to the most comprehensive and convenient health and wellness offering in the industry.” During his tenure at Kerr, Civello was a strong and welcome voice for pharmacists and the profession of pharmacy in general. I wish for two things: that Walgreens continue the tradition of professional values for which Kerr gained its fine reputation and that Civello continue to carry on his crusade for the profession.  

The second announcement is more worrisome. A recent study by the Centers for Medicare and Medicaid Services showed that a network of preferred pharmacies in Medicare Part D produced lower costs than nonpreferred pharmacies. And in an online blog from Capitol Hill Publishing titled “The Hill,” Mark Merritt, president and CEO of the Pharmaceutical Care Management Association, proclaims that “as policy makers continue to look for ways to bring down health care costs, specifically drug costs, they should encourage greater use of preferred pharmacy networks.” Now I don’t know the specifics of becoming a preferred pharmacy in one of those networks, but I bet the pricing of prescriptions is a big part of the picture. And while I understand the need to cut costs in health care, there are other ways to do this besides lowering the price of a prescription. A huge body of evidence confirms that providing personal, face-to-face consultations and medication therapy management will produce many of the same cost-saving results by keeping patients out of emergency rooms and reducing physician visits. When blogs concentrate solely on the price of drugs, they are ignoring the professional services offered by hundreds of thousands of pharmacists at retail pharmacies every day. The value of a retail pharmacy cannot, and should not, be judged on the price of prescriptions alone. The delicate balance between yin and yang in pharmacy must be maintained, for without the profession of pharmacy, there would be no business.

To comment on this article, contact editor@uspharmacist.com.

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