Fredrick S. Mayer, RPh, MPH

I wish I could say I envision a bright tomorrow for pharmacist compensation. I want that, but these four things must happen first.

We must come together and speak with a unified voice on basic ideals such as public health, patient support, and the proper place of pharmacists as valued members of the healthcare team. And I am convinced we must gain the support of government to radically overhaul the profit-oriented system to one that is evidence based, that eliminates insurance companies, managed care organizations, and pharmacy benefit managers.
	We need to change to a system that benefits the patient, such as a single-payer-type system like Kaiser.

A review of how pharmacies are owned and operated in Europe reveals a much higher appreciation for the pharmacist’s role in healthcare. Some European countries regulate pharmacy and pharmacist density to ensure the appropriate number of professionals per capita for their citizens. Pharmacists are organized into a union or guild to negotiate with governments on reimbursement. Many of these countries, such as Denmark, Sweden, and Norway, ban chains and insist that the majority of pharmacies are owned and operated by pharmacists.
	The Pharmaceutical Group of the European Union wanted to know whether weaker government regulation and the proliferation of chain pharmacies would result in better access to pharmaceutical care and lower drug prices. The study the group commissioned by the independent German firm OBIG examined practices in six European countries.
	The European study found: “Assuming increasing competition and cost-containment as the two key aims of deregulation, the research undertaken in this study could not provide any evidence that these goals have been achieved through deregulation of community pharmacies.” On the contrary, it found that prices did not go down, competition did not increase, and service was less personal with chains.

We Must Strengthen the Pharmacist’s Role

The CDC has shown that in 2017, 42% of all flu vaccines were administered in pharmacy outlets in the United States, saving thousands of lives. This was accomplished by better reimbursement and increasing pharmacy profits as a result of state legislation under provider-status contracts instituted by more than 20 states. This needs to be done at the national level by Congress.
	Unless regulation strengthens the pharmacist’s role, we will continue to have overworked, underpaid pharmacists and technicians forced to work under impossible circumstances, making grievous mistakes that result in injury and death. We will go right on being paid inadequate salaries to fill, count, pour, and type unreasonable numbers of prescriptions, with little or no opportunity to add life-saving value through counseling and consulting.

We can only achieve a desperately needed regulatory support by advocating for it with a compelling, unified voice. My colleague Dan Hussar writes frequently about the need for pharmacists to unionize under the employee chain pharmacists’ banner, and to correct the oversupply of schools of pharmacy. Pharmacy professionals must organize with new leaderships, legislation, and regulation.
	If we as a profession want to improve our own careers, and the health of our communities and our country, we had better focus forward and work toward these radical changes to save our profession. It’s time for a revolution.

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4 things that need to happen before pharmacists can expect improvements in compensation. 

Author | Fredrick S. Mayer, RPh, MPH

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