Mr. Eckel is professor and director of the Office of Practice Development and Education at the School of Pharmacy, University of North Carolina at Chapel Hill.
Recent years have shown how hard it can be to make sure pharmacy's needs are heard in Congress. We have seen some glimmers of hope, such as the recent success with the passage of HR 6331 in averting Medicare cuts. This is an unusual case, because we had strong allies in the other medical professions. It has demonstrated that we can succeed when we work together, however.
As budgets tighten even further, we can expect increasing pressure to reduce reimbursements. This will result in a continuing series of battles at state and federal levels and ultimately in proposals for more fundamental change to our health care system.
If change is inevitable, we must play a role in determining what that change will be. This means more than just fighting proposed reimbursement cuts—it means helping to define a new system that recognizes and rewards our professional knowledge and skills.
Pharmacy associations have begun to address this. The National Association of Chain Drug Stores issued a set of broad principles for health care reform earlier this year, covering most areas that directly affect us. The Association of Community Pharmacists Congressional Network has come up with much more specific proposals with the potential to define new ways that pharmacists can be reimbursed. These include a "PBM [pharmacy benefit manager]-less" system, in which reimbursements would be given at retail landed cost, plus a professional services fee. The group says that it has been asked by Rep John Conyers (D, MI), chairman of the House Judiciary Committee, to meet with other pharmacy groups to build consensus for the pharmacy provisions in any 2009 health care reform bill.
The statements emerging from pharmacy associations can help us focus on the issues, consider the options, and formulate our own position. Ultimately, it is up to each of us to identify what we want, then commit to helping shape the future—making sure that politicians hear our views. A successful health care program needs to support pharmacy—to ensure that happens, we must commit to being part of the process.
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