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Health Care Outlook 2023: Steven Anderson, NACDS

An article by McKinsey & Co. describes the current era with the words: “Return, Reimagine, Reinvent.” I cannot think of better positioning for our industry and for NACDS specifically in the association’s 90th Anniversary year. Our industry can look at the word “Return” from two angles.

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An article by McKinsey & Co. describes the current era with the words: “Return, Reimagine, Reinvent.” I cannot think of better positioning for our industry and for NACDS specifically in the association’s 90th Anniversary year.

steve anderson

Steven Anderson

Our industry can look at the word “Return” from two angles. On one hand, NACDS chain and supplier members empowered our nation’s “Return” from the COVID-19 pandemic. We remind all of our audiences: Though everyone wants the pandemic to be “over,” a major reason that we can even talk about “moving on” is the irreplaceable work of NACDS members.

On the other hand, NACDS members and their teams are executing their own “Return.” Like other businesses and industries, and like most Americans, they are considering how best to lead, to operate, to serve, and to thrive in the new context that the past three years have created.

That is where “Remagine” and “Reinvent” come in — not as concepts separate from the “Return” but as concepts integrated with the “Return.” We may never have seen a time of greater acceleration and ­transformation.

Just as NACDS has figured prominently in the industry’s journey over the past 90 years, and certainly throughout the pandemic, the association remains ideally suited to continue to serve as a catalyst for this industry’s successful and effective work on behalf of the American people and American communities.

This is the case because NACDS is the collective and collaborative will of the membership. As such, we have big things in store.

Future of pharmacy

Well before the pandemic, NACDS was focused on advancing policies that enable patients to benefit from the most accessible health care professionals: pharmacists. We also have long been focused on advancing policies that allow pharmacy teams — including pharmacy technicians — to optimize care.

The notion of pharmacies as the “face of neighborhood health care” and the fact that 90% of Americans live within five miles of a pharmacy are not new to NACDS. We have long known the impact that pharmacies have, and can have, for advancing health care access and equity, and for confronting social determinants of health.

The pandemic proved pharmacies to be irreplaceable. As of the writing of this article, pharmacies are rapidly approaching the level of giving 300 million COVID-19 shots. They are giving two of every three vaccinations. More than 40% of individuals vaccinated at pharmacies are from racial and ethnic minority groups, and half of pharmacy COVID-19 vaccination sites are in areas of high social vulnerability.

In 2023 the work will continue to prevent a rollback of the pharmacy access that Americans have come to expect. This will require a mix of federal and state advocacy.

In a conversation that NACDS had with one national reporter, the journalist said: “If we allow this access to roll back, that would undo the progress and lessons learned from the pandemic. Why would we do that?” That is the right question.

We must keep reminding policy makers: If your goal is to reimagine and reinvent health care access and equity, pharmacy already has written the playbook.

Consumer-empowered health and wellness

NACDS in 2022 launched a bold initiative called NACDS 2023. This initiative sustains a pro-pharmacy, pro-patient focus. It also advances broad health and wellness solutions throughout the store, through multidisciplinary care and through community partnerships.

The White House Conference on Hunger, Nutrition and Health that was held in September 2022 provided an amazing platform to showcase several aspects of NACDS members’ commitment to consumer-empowered health and wellness. NACDS 2023 aligns brilliantly with the conference’s goal to end hunger, to improve nutrition and physical activity, and to reduce diet-related diseases and disparities.

NACDS held a “satellite event” just a block from the actual conference in Washington, D.C. — consistent with the urging of the White House — to magnify the messages and focus of these important issues. One of the best examples of the authority of the NACDS satellite event is the magnitude of the organizations which participated alongside NACDS member companies.

Participants included: the American Cancer Society; the Reagan-Udall Foundation for the Food and Drug Administration; the Department of Health and Human Services Administration for Strategic Preparedness and Response; the White House COVID-19 Task Force; the Centers for Medicare and Medicaid Services Innovation Center; and the National Forum for Heart Disease & Stroke Prevention. We also featured prominently the Arlington Food Assistance Center — with which NACDS has collaborated for seven years.

In 2023, you will see NACDS 2023 continue to take shape in new and exciting ways. We will build on new partnerships within the health and wellness ecosystem; pioneer new pathways and reimbursement opportunities for health and wellness services; foster patient-focused enhancements of interoperability; and continue to tell our industry’s amazing story.

Together, we are writing the future.

The PBM reform imperative

Indeed, there are many opportunities for our industry to improve the lives of Americans. There also are challenges, which we are confronting together courageously and ­effectively.

As I write this, we are observing a two-year anniversary that patients and pharmacies can appreciate. With a unanimous decision on December 10, 2020, the U.S. Supreme Court upheld an Arkansas law that confronts the damaging tactics of prescription-drug middlemen known as pharmacy benefit managers (PBMs). NACDS had submitted an amicus brief in this case, Rutledge, Attorney General of Arkansas v. Pharmaceutical Care Management Association.

This Supreme Court decision is a potential turning point to address what really is “pharmacy benefit manipulation” by middlemen for their own profits. PBMs manipulate drug prices. PBMs manipulate patients’ relationships with their pharmacist. PBMs manipulate patients’ choice of pharmacies. PBMs manipulate patients’ access to the medicines a physician prescribes. PBMs manipulate their dealings with pharmacies in ways that jeopardize their viability.

Immediately, the Supreme Court’s unanimous decision reinforced laws similar to that of Arkansas in approximately 40 other states. Further, over the past two years since the Rutledge decision, more than 100 new state laws have been enacted to address PBM manipulation. Also of significance, the Eighth Circuit of the U.S. Court of Appeals in November 2021 upheld a North Dakota PBM-regulation law — in a case in which NACDS also submitted an amicus brief.

More work is needed. Fortunately, bipartisan commitment for PBM reform continues to swell in all levels and branches of government. We see this in the form of further legislation and executive action at the state level. At the federal level, Washington observers have identified PBM reform as an issue that could see results in the divided 118th Congress, given the bipartisan and intense support for this issue. The Federal Trade Commission also is conducting a study of the PBM industry, its tactics and its effects on consumers.

Sustained purpose and progress are necessary. The PBMs will not quietly let their power to manipulate slip away. At the federal and state levels, the PBMs will seek to roll back reform laws, to stymie the implementation of laws and to block any further progress.

NACDS remains committed to securing solutions at the federal and state levels that improve the health and security of patients and of the pharmacies that serve them.

Engaged members thrive at NACDS meetings

NACDS is an extremely unique organization with a high-energy vibe that can best be experienced at NACDS meetings and conferences. One of the best indicators of this vibe is the sense that NACDS wants everyone in the industry to succeed, and it shows.

This is on display at the first-time attendee events, which are led by seasoned NACDS chain and supplier member veterans. These veterans share insights that can help newer members learn how to leverage NACDS events for maximum results.

Further, these on-site sessions are the final tune-up that follows vigorous mentoring that in many cases has occurred throughout the months and weeks prior to the meetings and conferences. We look forward to putting the NACDS Regional Chain Conference, the NACDS Annual Meeting and the NACDS Total Store Expo to work for you.

It’s our time to “Return, Reimagine, Reinvent.” That is best done together through NACDS. We look forward to working with you in 2023, and we thank you for your engagement.

Steve Anderson is the president, CEO at the National Association of Chain Drug Stores.

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