Support local pharmacies

Thursday, September 1 2011 3:12 PM - by Brett Kappelmann

Editor: The recent closing of the Borders bookstore has me wondering what the citizens of Butler County would think if they lost the services of their local pharmacists. The possibility is real. The similarities to what shut down Borders, and the economic pressures facing retail pharmacy, are quite striking, except for one thing: Books are a commodity, drugs purchased at a pharmacy and the services provided by a pharmacist are not.

Those warehouse-like mail order operations are huge profit centers for these companies. Oh sure, they will "allow" local pharmacies to fill your immediate needs like antibiotics and diarrhea medicine. The problem is, neither an independent pharmacy nor any chain pharmacy could stay in business with those few prescriptions. If the mail order pharmacy trends continue unchecked, the days of having a trusted pharmacist to ask if this medication is right for you will come to an end.

What does this do to the local economy? Large companies that depend on local commerce for their very survival seem to have no problem sending millions of their dollars out of state each year for mail order pharmacy services. City, county and state governments do the same thing with your tax dollars being shipped out of state. This makes about as much sense as the unemployed factory worker hoping to get a local manufacturing job spending his unemployment check at Walmart on a kitchen table made in China.

It would be one thing if the drugs purchased via PBM (Pharmacy Benefit Manager)-owned mail order actually reduced or even contained an employer's drug cost, but they don't. Virtually every CEO I have spoken to has not seen their company drug bill decrease — ever — in spite of the fact that more drugs have gone generic in the last five years than ever.

As a pharmacy, we have seen our sales decrease in the past five years due to increased generics available for the same amount and type of prescriptions filled. The problem is the PBMs are retaining those savings at the employer's expense to fatten the bottom line. It's simple: They pay the pharmacy $17 then turn around and bill the employer as much as $217 and keep the difference.

So what can you do to save money and support the local economy? First be sure you have a relationship with your local pharmacist. He knows the most about you and your medication. Second, ask him if the drug (with no generic available) you are spending your $40 mail order co-pay on a three-month supply has a similar generic drug available in a generic. Then fill it at his store.

It may cost you three $10 co-pays to do it, but you are still saving $10, and you are creating local jobs. Don't forget, that mail house didn't try to help you. The local pharmacist took the time. If you send that generic off to be filled by mail, your local pharmacist might not be there next year. Today it is Borders, who will it be tomorrow?

Brett Kappelmann, PharmD.