By: Melissa Roy, Co-Copy Editor [Graphics Focused]
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During Pharmacy Lobby Day, pharmacists and students from all over New York gather at the capitol in Albany to meet with various members of Congress to discuss the state of pharmacy. This year, similar to previous years, a group of students and faculty from St. John’s University trekked up to Albany to make their voices heard. The opening session of Lobby Day was filled with inspiring speeches and words of encouragement from various members of Congress and PSSNY. Participants were separated into over 50 different groups and given various appointment times to meet with members of Congress. Here, they were able to convey concerns about various bills that would affect the future of pharmacy and healthcare as a whole.
I was a part of a group of students who were meeting with Congress members from Brooklyn and Orange County. It was an amazing experience to meet with our own congress members who, before then, were mere names on placards that littered streets and yards around election months. Of the two meetings, one was actually with my own town’s congressman, James Skoufis. Congressman Skoufis left a lasting impression – he was both courteous and eager to be involved in any effort that helped our district. He was truly interested in the laws that were directly affecting pharmacists, local independent pharmacies, and patients. He promised his support in Congress for the four major bills that we brought to his attention during the meeting.
At each meeting, we went over the four major bills that are currently affecting the face of Pharmacy. The first piece of legislature brought up was the Fair Generic Pricing Legislature, a bill of particular interest to those practicing in community pharmacies. The purpose of the bill is to enforce transparency on the part of pharmacy benefit managers (PBMs) and to demand more timely and properly handled adjustment of generic pricing disputes.
In normal situations, the prices of generic medications decrease over time. Recently however, there have been a slew of shortages and warehouse back orders of medications that have caused the cost of medications to skyrocket. Pharmacies are seeing prices jump by over 100-200% in a matter of days. However the reimbursement from insurance agencies is still based on the lower cost causing pharmacies to eat up the cost, fight with the insurance companies for proper reimbursement, or turn away their patients. Larger chains are able to afford the cost difference, or have their legal team fight for proper reimbursement. However, independent pharmacies are the suffering; they are forced to turn away their patients, leaving them without medication until the reimbursement can be adjusted, or sending them to another pharmacy altogether.
If this bill is passed it will require weekly updates on changes to the maximum allowable cost list, the ability to retroactively receive reimbursement on prescription claims, and create some much needed fairness in the contractual relationship between community pharmacies and PBMs.
The second topic discussed was regarding the Anti Mandatory Mail Order legislation (AMMO), which was passed in assembly in 2013. The original piece of legislature had several terms and conditions which had to be met in order for community pharmacies to be qualified to provide service to patients, as opposed to forcing the patient to rely on Mail Order. Some of the terms and conditions included having a nurse on site 24/7 even though most pharmacies are not open 24 hours. It also required pharmacies to pay obscene amounts to be certified by various institutions to be included in the “in-network” pharmacy list of the various insurance companies. The hope of this revision is to address the inequities brought on by the strenuous? Terms and conditions and ensure that the patient and their needs are given primary importance, and that they have the right to choose whether they want to use mail order or their local pharmacy.
The third bill discussed was the Immunization Authority Legislation, which was originally passed in 2008. Currently; the bill only allows pharmacists to administer immunization against the flu, pneumonia, shingles and meningitis. With the expansion of this bill, pharmacists will also be able to administer Tdap (combined Tetanus, Diphtheria and Pertussis vaccines). The bill will also eliminate the need for a patient specific order to be provided for the shingles vaccine, and most importantly eliminate the various sunset dates on the existing law and make pharmacist immunization authority permanent.
It is a widely accepted fact that pharmacists are the most easily accessible healthcare professionals in the country, which makes pharmacists the most obvious choice for public health initiatives such as immunizations. Pharmacists are trained to immunize, have a vast knowledge of medications, are always available to the public to answer any questions or concerns and New York is actually among one of the last states to not permanently authorize pharmacists to administer vaccinations.
The last piece of legislature is the expansion of pharmacist authority for collaborative drug therapy management (CDTM). This law plays the biggest role in allowing for the expansion and betterment of healthcare and the profession of pharmacy. CDTM allows for pharmacists and physicians/ nurse practitioners to work together to manage drug therapy and overall patient care to ensure that the best regimen is selected for the patient and that patient care is optimized.
The current law only allows for CDTM to occur in teaching hospitals and is also due to sunset this year; the hope is for the bill to be renewed and possibly to increase the reach of the law to include pharmacists outside of teaching hospitals. Collaborative therapy is the most efficient and effective way of guaranteeing optimal healthcare. Each member of the healthcare team brings a different perspective and insight, which when combined together allows for the best treatment regimens, better outcomes, and a decrease in hospital readmissions. CDTM will play a key role in creating a better and healthier future for the American public.
The importance of Lobby Day is often underplayed. It is an opportunity to make our voices heard, and fight for what we believe is vital to the prosperity of our profession and healthcare as a whole for the state of New York. People will constantly complain about the lack of change and oppressive laws and regulations, but are unwilling to make an effort to change the situation in their favor. By attending Lobby Day students are displaying that they want change, are willing to speak up, and make the effort to see that change occur. The congressmen and senators are placed in office by the votes of the people, so they have an obligation to work for the people and fight for their beliefs. Each and every law that was discussed and highlighted during Lobby Day will impact how the graduating classes of pharmacy school’s will practice; it will determine the future pharmacist’s role as healthcare providers and vital members of society. We can either sit back and let things happen to us, or stand together and speak up for ourselves, our profession and above all our patients.
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