Three Actions to Advocate for Pro-Pharmacy Legislation

In an exclusive interview with Drug Topics, Beth Mitchell, senior director of government affairs at AmerisourceBergen, explores the ways that pharmacists can take action on legislation that affects their practice.

Mitchell: Hi, my name is Beth Mitchell and I'm senior director of government affairs at AmerisourceBergen.

The power and the impact of independent pharmacy has been on full display throughout the pandemic as independent pharmacists maintain consistent care for patients and helped create equitable access to COVID-19 vaccines and tests. There has never been a more important time for independent pharmacists to get their voices heard by lawmakers and knowing where to start is often one of the biggest hurdles to overcome when engaging in advocacy at the local, state, or federal level.

So, I'd like to share 3 tips for pharmacists to consider to advocate for pro pharmacy legislation.

Tip 1 – Position yourself as a resource and tell your story

The first tip for pharmacists is, when meeting with an elected official - whether it's state or federal - definitely take the approach of positioning yourself as a resource and tell your story.

Legislators and their staff deal with hundreds of bills every legislative session, and every Congress, on a variety of policy topics. And they also have to serve and be a representative to thousands of constituents. Given the sheer number of issues that legislators work on and that they represent, care about, it's next to impossible for every elected official to be an expert on every piece of health care legislation.

However, pharmacists are in a unique position because pharmacists can help position themselves as the subject matter expert on pharmacy, medication, and reimbursement issues. And as health care subject matter experts, pharmacists really know the intricacies of their industry and the regulations that govern what they do. And I think that puts pharmacists in a very unique position to offer the insight, explanations, and technical information on pharmacy and many health care issues that an elected official really needs to hear in order to make an informed decision on a piece of legislation or public policy.

Independent pharmacist also have an incredible story and a wealth of knowledge to share with legislators. They're obviously an incredibly accessible point of health care in our country. And independent pharmacists have also proven themselves as essential health care destinations throughout the COVID-19 pandemic.

In addition to that, independent pharmacists are voters in their state or local community and constituents of several elected officials, so they have that unique perspective that a lot of health care experts don't have because they're not only providing care directly to the patient, seeing their patients and knowing them every day, but they're also coming from a voter and a constituent perspective, in addition to having that expertise in health care.

I think pharmacists, when they take the time to really highlight their real world experiences and share stories with elected officials about issues, that they'll find a highly receptive audience in elected officials. If a pharmacist is preparing for an upcoming meeting with a legislator, whether it's local, state, or federal, I would really encourage the pharmacist to do their homework before the meeting and come prepared with facts and data on whatever the policy topic may be, so that they can show the legislator their expertise and help to build that trust and relationship with the elected official.

Doing that homework ahead of the meeting will also help to make your advocacy arguments that much stronger. Being prepared with real world, real life stories that you can share with an elected official on a topic that you care about and helping connect that back to the elected official about why those legislative issues important to them – sharing examples of a real world scenario in your pharmacy that impacted you or impacted your patients, having data related to percentage of Medicare, Medicaid population you share – doing all of that homework and taking the approach of positioning yourself as a resource will really go a long way and help to make your advocacy arguments and your presence that much more effective.

Tip 2 – Do your homework and be clear with your ask

The second tip I'd like to recommend to pharmacists is make sure you know going into a meeting clearly what you want to ask the elected official to do and what action would you like them to take.

Do that preparation before you walk into the meeting and have in your mind what do you want to ask them to do to help with. Frame your ask in a way that's truly easy for the elected official to understand. It's important not to assume that lawmakers know every potential aspect of a pending policy or piece of legislation related to independent pharmacy issues. But if you walk into the meeting and you show the legislator that you've done your homework, you know exactly how they can help and take action on an issue, that will really make a difference.

When you're going into a meeting, take the time to prepare and know what piece of legislation would you like for them to consider and develop in your mind and in your arguments why is it important, and how can you connect that back to the elected official to their state or their district, and why it matters for their constituents.

And then after you've explained the topic in an easy-to-understand way, make sure you're very clear about what ask you'd like them to do. Would you like them to co-sponsor the bill? Would you like them to - maybe they already are a co-sponsor. Would you like them to ask another legislator in your state to support the bill as well? We have seen an incredible form of advocacy, especially at the state level since December of 2020, when the United States Supreme Court ruled in favor of an Arkansas state law regulating pharmacy benefit managers’ (PBMs) reimbursement practices. And this was a unanimous landmark ruling that really has paved the way for other states to enact similar legislation and take regulatory action to prevent PBMs from under reimbursing pharmacists. And I think that this is an excellent example of an issue where pharmacists can really do their homework before they go into a meeting with an elected official, and go in and take action and ask the legislator to take action.

We’ve seen, just this year, nearly 300 bills in 48 states pending seeking to regulate or reform PBMs in some fashion, and more than 50 of those have been enacted just in 2021. So, clearly, independent pharmacists are making a big difference. And I would encourage you to also look into your state and see if there are similar bills pending that are modeling the Arkansas law or potentially taking different approaches that could potentially help the pharmacy profession, your businesses and your patients.

Tip 3 – Engage in grassroots and grasstops calls to action

Most importantly, the third tip I'd like to recommend for pharmacists to really think about when they're advocating for legislation is to take the time to get involved in grassroots and grasstops calls to action.

There are a variety of bills, state and federal, that pharmacists can get engaged in today. In order to do that, for example, there's current bills pending in Congress that would potentially address pharmacy direct and indirection remuneration (DIR) reform. The Pharmacy DIR Reform to Reduce Senior Drug Costs Act has been introduced in both the House of Representative and the Senate. It's bipartisan and bicameral.

There's also legislation and a strong effort this year to enact a permanent federal law to recognize pharmacists as providers in Medicare and I think we'll be seeing more evolving in that area. And those are 2 examples of issues that pharmacists can get involved today in grassroots or grasstops engagement.

And AmerisourceBergen has a variety of resources to help pharmacists do that. So, for example, we have a website called Our Independent Voice, which is publicly available; any pharmacist or pharmacist advocate can go to that site. And we share a lot of updates on the latest updates page. We also push out state and federal grassroots calls to action to our Good Neighbor Pharmacy (GNP) pharmacists and independent pharmacy customers, encouraging them to get engaged. We're not the only ones doing this. I'm sure many of your state and local and national pharmacy groups have similar efforts.

And you may think, “Oh, well I don't have time,” or “I'm just sending another letter, another email or another phone call,” but that's really not the case. Your voice, as a pharmacist, a voter and a constituent in your community is incredibly impactful and elected officials want to and need to hear from you. And they absolutely keep track of these types of communications coming in from their constituents into their offices.

So, again, grassroots and grasstops efforts can take a variety of forms. It can be a phone call a letter and email. I've also seen some very effective video messages that pharmacists have recorded and shared on LinkedIn, Twitter, Instagram, Facebook, and then tagged elected officials. And that message, that's a great example of a grassroots tool you can use. And then from a grasstops perspective, there's many pharmacists, especially independent community pharmacists that have direct relationships with elected officials - their children might go to the same school as their local mayor or state representative. And if you have these types of relationships, then that gives you an opportunity to really participate in a grasstops initiative and take the time to build upon that relationship.

Find specific time to meet with the elected official about pharmacy legislation and discuss ways that you can potentially work together to achieve your goal, whatever that might be, on a piece of legislation or public policy.

These are examples of some quick actions that pharmacists can take to advocate for pharmacy legislation. Again, please take the time to do it. It's worth it. And on almost every piece of legislation I work on related to pharmacy, whether I'm speaking with a member of Congress, a governor, or a state legislator, they asked me, “Are they hearing from pharmacists?” They asked their staff, are they hearing from pharmacists, so they absolutely want to and need to hear from the individuals in their community that are serving patients.

I also would recommend the National Community Pharmacists Association (NCPA) and the American Pharmacists Association (APhA). They have some excellent legislative and grassroots resources and action centers, so I encourage you to visit those pages as well.

And then lastly, our government affairs and policy team at AmerisourceBergen is working to be more active on social media, so anyone interested to follow along the legislative work that our team is doing on behalf of AmerisourceBergen and our customers, to follow @advocacy_ABC on both Twitter and Instagram.

And so, in closing, I'd like to say thank you to all independent pharmacists for what you do every day, but especially all you have done throughout the last year and a half during the COVID-19 pandemic, you are truly making a difference in patients’ lives. And you can make just as important of a difference when you take the time to leverage the power of your own voice and experiences and share those with elected officials to educate them and encourage them to take action on important public policy issues.

Change definitely doesn't happen overnight, especially in the legislative and political arena, so I'd encourage you to take the time to take those steps, stay engaged, and continue to advocate because significant and lasting advances for the pharmacy profession will occur and have occurred, but you have to continue to build upon that and stay engaged. Thank you.