Texas is a state that far too often finds our health care system in the headlines for all the wrong reasons.
Whether it’s our staggering numbers of uninsured Texans or concerns about affordable, accessible health care, Texas has many challenges our state leaders must address.
Unfortunately, a move that was no doubt difficult for lawmakers to approve back in 2011 during a very tenuous budget shortfall has come home to roost.
An effort to save the state tax dollars resulted in a shift of the Medicaid prescription drug program into managed care organizations and into the hands of out-of-state pharmacy benefit managers, whose contracts are shielded from view.
That fateful move today not only sacrifices patients’ access to health care, it is driving small businesses – independent pharmacists like us – toward bankruptcy. And, to add insult to injury, it’s a move that simply has not generated promised savings for taxpayers.
The Alliance of Independent Pharmacists, with support from Texas TrueCare Pharmacies, recently released a white paper on these shortcomings.
The problems of this transition are especially acute for low-income Texans, the elderly and the pharmacies that serve them. In fact, independent pharmacies represent roughly 2,000 small businesses across Texas and serve a high percentage of Medicaid clients, especially in rural areas. And, these small businesses employ about 20,000 professionals and other support staff. These jobs are at-risk. Increasingly, independent pharmacists are unable to maintain stock of costly, life-saving medications for any of their patients due to the lack of reasonable reimbursements from the state.
In order to limit this negative impact on all our patients, independent pharmacists are asking budget writers to pay a more reasonable rate to their small business partners under Medicaid and CHIP.
When you look at the bottom lines of these small businesses, 80 percent of a pharmacists’ costs is the cost of goods – the prescription drugs sold – and only 20 percent is related to professional services provided by the pharmacists.
A broad coalition of pharmacy and patient access groups, including the Texas Pharmacy Association, Pharmacy Choice and Access Now (PCAN), Texas Pharmacy Business Council, Texas Federation of Drug Stores, Texas TRUECare Pharmacies and the National Community Pharmacists Association (NCPA), have proposed solutions to further reform the Medicaid prescription drug benefit and we’re hopeful that efforts to also examine contract transparency, affordability and access are also carefully considered this session and in the interim.
When small business pharmacies across our state and taxpayers are suffering under Medicaid’s prescription drug program in managed care six years after the recession, it’s time for state leaders to help cure what ails all of us. A small, but simple first step would go a long way toward ensuring Texas’ safety net for health care and the backbone of Texas – its small businesses – are strengthened.