This week in Florida there was a man named Loeffler from a big company called HEB that made a bold statement. He said and I quote "In Texas they say that if it looks like bull crap, and it feels like bull crap, and it smells like bull crap, then it probably is genuine grade A pure bull crap". Kudos to Mr. Loeffler for making that statement about the ExpressScrips/Medco merger. He also said that Medco chairman and CEO David Snow is in line for a 39 million golden parachute. Quote "now who does it look like has been using the lack of transparency to shovel big money their own way as opposed to driving health care costs lower?" BTW Mr. Loeffler is chairman of NACDS. Pretty bold. Thanks Mr. Loeffler for calling that particular kettle black.
On another note this week I received a nice fax from my friendly pharmacy co-op asking me to join the "revolution" (yes, using lots of quotation marks today). What's this you say. The new RxAlly revolution. There was a link so I proceeded to watch a 45 minute press conference and I must say at the end of presentation I was just as confused as in the beginning. Here's the skinny. The RxAlly CEO is Bruce Roberts. Remember him, former NCPA CEO who took credit for starting such things as SureScripts and Mirixa. Well he's back and has partnered up with our dear neighbor down the street; Walgreens. RxAlly is a for-profit company that not only has Walgreens as an owner but our very own co-ops. See if you recognize yours: Academy of Independent Pharmacy of Georgia (AIP), American Associated Pharmacies (AAP), American Pharmacies (APRx), American Pharmacy Cooperative, Inc. (APCI), Carolina Allied Pharmaceutical Services (CAPS), Chain Drug Consortium (CDC-lots of non stock market chains), EPIC pharmacies (EPIC), Independent Pharmacy Cooperative (IPC), PBA health (PBA), and Pharmacy Providers of Oklahoma (PPOK). Whew, what a mouthful. Let's discuss this new alliance.
RxAlly claims to have 20 thousand member stores. In reality they have the CEO's of the various groups and their boards. NOT their members. I understand per RxAlly's website that each store must sign up (or was it each pharmacist?) so that tells me they have nothing in the way of a network so far. I understand the concept but let's be transparent here. What is the purpose of RxAlly? Wait, here it is. Quote "Help patients achieve better health through personalized pharmacist care while reducing costs." Great concept..Why did RxAlly go with pharmacy buying groups as partners in order to provide these services. You would think they would have gone with more professional groups say like: APhA (American Pharmacists Association), NCPA (National Community Pharmacist's Association), ASHP (American Society of Hospital Pharmacists), ACA (American Colleges of Apothecaries), AACP (American Colleges of Pharmacy) or NASPA (National Association of State Pharmacy Associations). I didn't see any of these folks during the press conference. All I heard was the 280 billion dollar waste (and the 20 year old Ashville study) and how PHARMACISTS could help lower this cost to EMPLOYERS... How does a co-op or Walgreens (who are profit driven) even begin to be above board in bringing savings to patients. Greg Wasson, CEO of Walgreens said it was about the PROFESSION of pharmacy and changing the landscape. Ok, cool, but why do you need a drugstore for that change? Why couldn't pharmacist's provide that service from home or on their off days? I wonder how many people involved in this start up has EVER provided a clinical service. It looked to me that there were a bunch of white headed CEO's in the room who I bet haven't worked the pharmacy counter since Nixon was president. One thing I didn't hear a lot about during the press conference was how pharmacy was going to be paid for performing these services. Still a mystery. I wonder how many pharmacists will make up the board for RxAlly? I bet there will be a few but probably most will be CEO's and MBA's. There may not be a single independent pharmacy owner on that board. (I bet not). Just a ramble or two more.
It seems to me that Walgreen's (being shut out of ESI and soon Medco) is looking for a way to shore up it's losses so that big Wall Street investors will continue to funnel money to them.(they just bought BioScripts, a big mail order speciality pharmacy) They have a great game plan. Let's look at how independent pharmacy survives and copy that! (and still keep our mail order and central fill facilities and our buying power) Wow, and now let's form a company so we can learn from them first hand; (remember who Bruce Robert's used to work for?) and to get their buying groups on board as well.(why didn't the co-ops do this on their own, who needs Walgreens) This being said I would ask Mr. Wasson why the rest of the profession wasn't at the table? If it's about moving the profession then let's get the profession to embrace change. The RxAlly model is not new (maybe the Walgreen's part). Independent pharmacy has been taking care of patient needs forever. That's why most pharmacist's want to own their own store. So they can practice how THEY want and take care of folks how they want. Not how some MBA CEO tells them. Bruce Roberts says that "There is a need for greater access to health care for patients throughout the U.S." All patent's have access, just not everyone is willing to pay. Everyone wants lower cost but no one wants to pay for it. It also makes me mad as HE double hockey sticks that EVERYONE skirts the real reason we have such high health care costs in America. WE Subsidize the world!! If we paid for our drugs like other countries we could reduce pharmacy costs by billions. (and even pay our pharmacies more). If we regulated the manufacturers and middlemen (PBM's, TPA's etc) and taxed them appropriately we could save billions more. Our system is set up for making a few people rich (1%) and the rest of us paying the price(99%). We have multi billion dollar companies running rampant over small business and a congress that holds out it's hand and looks the other way. Tell us what you want us to hear and put that money in your pocket. I hope RxAlly achieves it's goal, but I will tell you I am sick and tired of working for free. I hate to think that a middleman (RxAlly) is going to negotiate with payers for my services and then tie my performance to a contract. When I perform a service for my patients they pay my price (outside of filling a prescription) and they are usually very happy with the outcome (everyone wins). I think that since about 100 percent of our prescriptions are dictated by PBM's, that other entities see pharmacist services as an area they can exploit (and make themselves rich in the process). You know this model has worked before. Are your Surescripts transactions free yet? Let me now quote the Beatles.
"You say you want a revolution, well you know, we'd all want to see the plan. You ask me for a contribution, well you know, we're all doing what we can. But if you want money for people with minds that hate, all I can tell you is brother you'll have to wait. Don't you know it's gonna be alright."
More on this subject later. I've got to clean out this stall. You know they have bull's in all 50 states.
Kris
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