NCPA finds reasons for optimisim

November 5, 2007

At its annual convention the Nation Community Pharmacy Association pushes for greater political influence, medication therapy management, and new business models.

According to the NCPA-Pfizer Digest, which was released at the convention, for the first time in five years the number of independent pharmacies declined in 2006. Even as the number of chain, mass-merchandiser, and supermarket pharmacies rose, the number of independent pharmacies dropped by 1,152 to 23,348. In addition, sales per location fell 3.5% to $3.6 million and gross profit was the lowest it has been in the past 10 years at 22.8%. Similarly, net operating income dropped by .9%, to 2.8%-also the lowest it has been in the past decade.

About the only thing that did rise for pharmacies was the total number of prescriptions dispensed. Pharmacies dispensed, on average, 61,087 prescriptions per year, or about 196 each day. Of those prescriptions, a larger percentage was through government healthcare programs. Medicaid and Medicare now constitute 39% of all prescriptions dispensed, while other third-party payers dropped to 52%. The remaining cash payments dropped to 9%, down from 20% in 2002.

Given the increasing role of Medicare and Medicaid programs, it is hardly surprising that NCPA has put a renewed emphasis on the work of its political action committee. At the conference, Roberts boasted that the NCPA PAC raised $100,000 at the convention and was on target to collect more than $1 million for the 2008 elections. NCPA is planning on hosting receptions at both the Democratic and Republican national conventions in 2008.

One of the results of NCPA's increased political clout has been the formation of the Congressional Community Pharmacy Caucus. The group, which was formed in September, already has more than 50 members that support measures to protect community pharmacies. "The caucus will serve as a permanent platform for sharing ideas, news, and research on community pharmacy legislative issues on Capitol Hill," Roberts explained.

According to Roberts and Charles Sewell, NCPA's senior VP of government affairs, the caucus is pushing legislation to address a number of the most vexing issues facing community pharmacy. Bills have been introduced in both the House and the Senate to fix the average manufacturer price (AMP) rule that is set to go into effect in January. According to Sewell, Sen. Max Baucus (D, Mont.) has suggested that the bill may be included in a major Medicare and Medicaid bill that is expected to be voted on in December. Sewell also noted that pharmaceutical companies are also hoping for a delay in the rule's implementation, citing difficulty in gathering the required data.

In addition to the AMP bill, NCPA has been busy lobbying Congress on several pharmacy bills. According to Roberts, caucus members were helpful in passing a last-minute bill that delayed implementation of a new rule requiring tamper-resistant prescription pads for Medicaid prescriptions and are pushing for prompt-pay legislation. The groups also helped kill a proposed bill that would have given the Food & Drug Administration greater control over compounding.

New opportunities

In addition to increasing NCPA's clout in Congress, members were urged by Roberts to move beyond dispensing to increase involvement in medication therapy management, e-prescriptions, and specialty pharmacy. Roberts touted the organization's ventures with Mirixa for MTM and SureScripts for e-prescribing as tools for independent pharmacists to diversify and modernize their businesses. He also noted that independent pharmacists lag behind chains for e-prescriptions. "We are behind the curve," he warned. "E-prescribing is not coming. It's here, and we have a ways to go."