The Government, Here to Help
Articles on this topic begin with the same piece of advice: Talk to your pharmacist. I imagine every time pharmacists hear this sort of advice being given, they must sigh. It’s not that they don’t want to talk to us. It’s just that between filling prescriptions, fielding phone calls and administering vaccines, they don’t have enough time.
Ronald Reagan famously said, “The nine most terrifying words in the English language are, ‘I’m from the government, and I’m here to help.’” In this case (and perhaps in others) he may have been wrong. Having the government turn a regulatory eye toward PBMs is a good thing.
The inner workings of PBMs are famously opaque. Ohio State Senator Dave Burke makes the following analogy: “If you knew how much a yard of concrete costs, you know how many yards are in a mile and you can estimate how much you should spend on concrete … When the person who is doing that work isn’t telling you how much they paid for the concrete—they just tell you how much it costs for a mile of road—that gets to be a very expensive highway.”14
Increasingly, both state and federal governments are noticing the tremendous role PBMs play in the delivery of nearly 6 billion prescriptions in the U.S. every year.15 Greater transparency in this industry should benefit all of us.
This won’t be enough, however, to extricate pharmacists from their current situation or allow them more time to provide vital clinical services. For pharmacists, it’s hard to imagine anything but a legislative solution. With this in mind, in 2018, Illinois established the Collaborative Pharmaceutical Task Force, which was “charged with discussing and making recommendations on how to further advance the practice of pharmacy in a manner that recognizes the needs of the healthcare system, patients, pharmacies, pharmacists and pharmacy technicians.”16
The task force has made several recommendations to the Illinois legislature, including mandatory work breaks and penalties for pharmacies who fail to give their pharmacists an adequate amount of time to do their jobs properly and safely.
In 2000, the Doctor of Pharmacy degree became the entry-level pharmacy degree. This clinical degree gives pharmacists education and patient experience they would be eager to put to work—if only they had enough time to do so.
Even legislating pharmacists’ time may not be enough. Notably, the task force elected not to set a maximum number of prescriptions that pharmacists could be expected to fill in an hour, deeming such thresholds arbitrary. The task force was also silent on what sort of penalties should befall a pharmacy that sets unreasonable productivity goals for pharmacists.
That said, it’s a good start. I hope other states follow suit, because it’s important that we acknowledge pharmacists for what they are—a vital link in the delivery of healthcare for our patients.
After all, my nephew is counting on them.