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Using Blockchain technology, the new program will legally redispense expensive medications to those who cannot afford them.
Blockchain technology’s introduction into the pharmacy industry was one focus in our January future trends issue.
“Blockchain is defined as an open record of transactions, or a ledger, that can be made and distributed to several stakeholders instead of being maintained in one location,” Donna Marbury writes. “Because the integrity of the data is distributed across several blocks, data tampering is more difficult, and transactions are easier to trace.”
Ultimately, the technology will saturate the pharmacy supply chain, and challenge fraud and waste amid the ongoing opioid epidemic. But the technology may also provide another use-connecting underserved populations with necessary medications.
Philip Baker PharmD is the founder of both Good Shepherd Health Pharmacy (GSP) in Memphis, TN, and Remedichain, a new platform using the blockchain technology and partnering with major cancer centers around the nation. Building off of one of the pharmacy’s founding principles, Baker hopes to use blockchain to connect unused prescription medications with populations most in need.
DT: How did Remedichain evolve from GSP?
Baker: GSP opened in September of 2015. We are a nonprofit 501(c)(3) charity pharmacy. We opened with a supply of meds that we got through manufacturer donations that were for low-income, uninsured people. That was great. but it wasn’t nearly enough. Drugs that we couldn’t get through donation, we started buying and selling at cost.
I knew that I was never going to contract with PBMs. We are not registered with Medicare or Medicaid. We don’t want to play with any third parties – we would always be a direct-to-consumer business. Donated medications allowed us to get started buying drugs and selling them at cost.
I worked six years as a pharmacy manager in retail. I saw people leaving their medications at the counter because they couldn’t afford them. It was just criminal, to be quite honest. ‘Clawbacks’ are well documented now, but 10 years ago I was seeing that.
We believe that the value a pharmacist provides is completely independent of the cost of the medication. Whether it's a $1 or $100 pill, the value that we bring to the table remains the same. The education, the medication review, counseling the patient. It doesn’t matter what the cost of the pill is.
We set up a membership pharmacy, three-years running now. Our members pay a fixed monthly membership fee. If we can get their medications for free through donations and [the members] qualify, then we dispense those for free. If we can’t, then we order the meds and sell them at cost.
We’re honest about the costs, and we actually lose money when it’s all said and done.
In the state of Tennessee, [medication reclamation] was illegal. Back in 2016, I started to get the law changed. I researched every reclamation program in the country; looked at the laws in every state, and found that a lot of states had laws that would allow programs.
I knew if we started a program, we had to figure out how to make it financially self-sustainable. The longest and most successful program in the country is SafeNet in Iowa. They’ve been reclaiming medicine and redispensing for seven or eight years for several million dollars, but they’re completely dependent upon money from the state. If their funding were to get cut, they would go out of business. I didn’t want to go down that road.
And that was pretty much the genesis of Remedichain.
Last February, I started learning about Blockchain. There are several movers in the pharmacy space and blockchain because it is such a good use case. I was surprised to find out how early on we are.
[My presentation at the FedEx Institute of Technology last year] opened the door. I've learned more about Blockchain as a workaround with PBMs, to just work directly with the customer and a new infrastructure that could allow you to build the “claims.”
For example, I can work with an employer and fill prescriptions for his employees and just bill him directly, without having to run [the bill] through the PBM and have the pharmacy’s money tied up for six weeks waiting to be reimbursed.
Q: How does this program work?
Baker: Any individual donor will go to our website, register the donation, and mail the donation to us at their own expense or take it to one of our local partner donation cancer center sites. (The website will capture all of the HIPAA-related stuff.)
Oncology clinics can partner with us and it doesn’t cost them anything. [The clinics] don’t have to maintain any sort of paperwork, just have a box to accept donations. When we get two or three donations, we’ll come and pick it up. We’ve tried to make it as easy as possible with no extra work for the cancer clinics and no liability.
Q: How do you plan to expand Remedichain’s services and scope?
Baker: What I don’t want to do is build a megapharmacy in Memphis. My goal is to redefine what community pharmacy is and to give local independent pharmacists tools to keep their doors open.
The system we’re building is twofold.
It allows the independent pharmacist to contract and create an infrastructure outside of PBMs. The same system will be used to scale our nonprofit pharmacies, which [distribute] the donated meds. It’s a new way to do claims that doesn’t take a huge cut out of the pharmacy’s pockets. It makes drugs cheaper, and the profit margins higher-it’s a win-win.
Remedichain is focused on oncology meds. Oncology clinics can partner with us and it doesn’t cost them anything. That’s intentional, but not all we plan to do. We want to reclaim and reuse anything of value. To that end, we have connections in Tennessee and Iowa. There are 14 other states where we have partners. It’s definitely a national program in scope.