NACDS CEO: Retail Pharmacies See an Acceleration of Key Issues in the Field


Although the COVID-19 pandemic may have ostensibly required global populations to stand still, this stillness shrouded what was in fact a period of extensive acceleration.

As much of the world increasingly shifts its view to a future beyond the pandemic, a focus on the priority issues of the members of the National Association of Chain Drug Stores (NACDS) has also accelerated, according to NACDS president and CEO Steven C. Anderson, FASAE, CAE, IOM, during a session at the 2022 NACDS Total Store Expo. Anderson explained that although the COVID-19 pandemic may have ostensibly required global populations to stand still for a time, this stillness shrouded what was in fact a period of extensive acceleration.

“It was a time of acceleration—the acceleration of digital progress gets a lot of attention—it advanced by 7 years, according to some estimates,” Anderson said. “This acceleration describes our top issues at NACDS, and these issues include expanding pharmacy care services, expanding health and wellness solutions throughout the pharmacy and the total store, defending pharmacies from unfair reimbursement, and defending patient care.”

Anderson noted that the pandemic also helped to confirm the case for pharmacies as a hub of neighborhood health care. As patients turned to local pharmacies for health care needs due to access barriers and safety concerns during the height of the pandemic, pharmacists took on a greater role in patient care than ever before.

“The pandemic confirmed our case and redoubled our resolve,” Anderson said. “These issues are accelerating now because people know that retailers and suppliers were there when it mattered most, with accessible and equitable care. The examples of this recognition [from the public] are endless.”

Anderson explained that pharmacists are taking this recognition and turning their resolve to focus on gaining even more victories for patients and for an overall pro-pharmacy agenda within the health care industry. At NACDS, this resolve has helped to develop a 3-part strategy to keep up the current rate of acceleration on issues of importance to retail pharmacy.

“We’re working to extend the federal flexibilities under the Public Readiness and Emergency Preparedness Act (PREP). These flexibilities empower pharmacies to provide services for COVID-19 and other illnesses,” Anderson said. “And we need to create a reliable reimbursement mechanism for these services.”

Furthermore, the desire of NACDS to extend the flexibilities provided by the PREP Act is not only one held by stakeholders in the pharmacy field, as the public shares in this interest as well. Based on the results of a Morning Consult poll commissioned by NACDS, 70% of adults support extending these policies, and 68% of adults want to make them permanent, according to Anderson.

Additionally, Anderson noted that other surveys have shown a similar shift demonstrating consumers’ preferences in this area, with a JD Power survey showing that customers are now looking to retail pharmacies as hubs for broader health and wellness services.

“It’s an opportunity for retail pharmacies to innovate and become a one-stop shop for routine care. This shows the timeliness of a new initiative, which we’re calling NACDS 2023. This initiative will answer the question: How does NACDS best support the work of retailers and suppliers to meet Americans comprehensive health and wellness needs?” Anderson said. “All of this is accelerating as a result of the pandemic.”

However, even with these victories, Anderson noted that there remains a particular set of reimbursement issues for which NACDS has learned it must constantly remain vigilant.

“And I’m referring to pharmacy benefit manager (PBM) issues,” Anderson said. “To anyone in pharmacy, this is an existential battle. And these aren’t new issues.”

Yet, Anderson noted that, along with the acceleration of other issues for retail pharmacies, there has been tremendous progress on PBM reform. Anderson explained that, for example, the US Supreme Court in 2020 sided with NACDS on a ruling that upheld an Arkansas law that regulates PBMs.

“That set off what can only be described as an acceleration of this issue,” Anderson said. “In 2021, states introduced over 300 PBM transparency and reform bills, and 53 were enacted. In 2022, 371 reform laws have been introduced or carried over from the prior year, and 38 have already been enacted. That’s a total of 91 new PBM reform laws in 2 years, just since that Supreme Court decision.”

There has also been federal progress in PBM reform, according to Anderson. In 2022, the Centers for Medicare and Medicaid Services finalized a rule improving transparency for pharmacy direct and indirect remuneration (DIR) fees. Anderson noted that DIR fees significantly impact seniors’ out-of-pocket costs and crush pharmacies financially.

“The new rule is a positive step, yet much more needs to be done,” Anderson said.


Anderson SC, Nightengale B, Summers L. Business Program. Boston, MA: 2022 National Association of Chain Drug Stores Total Store Expo; August 28, 2022.

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