Distribution Networks: Why Limit Them?

Specialty Pharmacy Times, July/August 2013, Volume 4, Issue 4

The idea that patients’ access to medications should be limited seems like an exercise in the lack of common sense—if the ultimate goal is to get the right medications to the right people at the right time. In this issue of Specialty Pharmacy Times, we investigate the complex relationship between the key stakeholders in the distribution of medications—pharmacy itself, payers, and the product, which translates to the manufacturer or pharmaceutical company. How do these players interact and how do medications reach the patients who need them? You’ll want to read our cover story, “The 3 P's of Specialty Pharmacy: Pharmacy, Payer, and Product” for insight into these worlds.

Clearly, everyone involved in the distribution networks has their own mission and goals, but in “Specialty Speaks” we also hear from a specialty pharmacist who wonders why limited distribution networks are found only in the United States. Speaking as a businessperson, he can understand the ins and outs of basic cost control, but then asks, “In a country that was built on the fundamental principal of ‘freedom,’ do you really expect that our founding fathers wanted to exclude our health care from this freedom?” As a staunch advocate for patients, this seems to be an important question to ask.

There’s another part to this question. If the United States government is the largest payer of health care—and universal health care is on the table with Obamacare, no matter what the public thinks of it—then shouldn’t we be looking very closely at restricted networks and how they impact costs? As the author of “Specialty Speaks” says, “A concerned citizen should worry about allowing these networks to continue and who is going to fund them. How can Congress, knowing we are facing the largest deficit of all time, not be concerned?”

It seems that Congress needs to listen to all of the players in this scenario, including the opinion of this specialty pharmacist who is looking for access to medications for all patients and any willing provider, while still ensuring strict standards to optimize the best care. Rising costs in health care was one of the fundamental reasons that health care reform first took hold—and was translated into what we are struggling with today—so this needs to be addressed.

The answers can be complex, and as our cover story says, “There is not a single choice and through rigorous process the decision distills over time.” Let’s not forget about an individual’s freedom of choice and the value of limited government in the process.

Thank you for reading!

Mike Hennessy

Chairman/Chief Executive Officer