Can't wait to see how the pharmacy school deans spin this one. The UC Irvine dean explained away the 0% growth update as "negative retail growth balanced out by positive growth in clinical positions, and we're training our students to be clinical pharmacists"... The grand irony is that I researched this person and turns out she was a pharmacoeconomics professor so she should know numbers... shame on her...Yes it is getting worse. How low will it go?
Home : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics
The Occupational Outlook Handbook is the government's premier source of career guidance featuring hundreds of occupations—such as carpenters, teachers, and veterinarians. Revised annually, the latest version contains employment projections for the 2021-31 decade.www.bls.gov
Remote verification, kiosk/concierge pharmacists and telepharmacy is going to obliviate retail pharmacy. Pharmacy techs have advanced more as a profession than pharmacists in the last 5 years, so I am very much expecting this trend to continue, which means legislative changes to unlock high privileges for techs will start to come through faster. At the end of the day, paying a desperate new grad $30/hr is still ... $15/hr you can save if you hired a tech instead.
This isn't going to last long. With all the law suits happening as we speak, PBMs will eventually have to draw back their abuse unless they just flat out change the laws. You can only bully someone so much before they go berserk on you for threatening their livelihood. One can argue that with enough bribing, they could potentially change the laws to a point where the entire pharmacy is run by technicians only. If this is actually possibly then, it's not just the pharmacy profession that is going to be threatened. PAs and nurses have tried with little success last time I checked. 4 years of med school, 3-6 years of residencies cannot be replaced with PA and nursing degrees, just like tech training cannot replace pharmacy school education. Sad thing is pharmacy school quality is going down the toilet fast. We need to close down half of schools right now.
You don't know that. There are people working diligently trying to abolish PBMs and regulate insurance reimbursements. This alone should help our profession greatly.
LoL you think PBMs/corporate retail are scared of "bullying" their pharmacists too much or retaliation? There are 15,000 desperate new grads with $200k+ loans (actually with inflation nowadays it's more like $300k+ but who's counting) who will die to have an opportunity at employment. Irrelevant phenomenon here.
:
Scared? No, i'm sure they're not. Why would they be? and who said anything about them being scared? They bullied the pharmacies for years. Pharmacies have stayed silent but when you squeeze hard enough and long enough, retaliation is inevitable.
Pharmacy deans are so clueless, some of them didn't even know what DIR fees are. We need the right leaders, otherwise all these new crappy schools are gonna keep on popping up.
And all I'm saying is that there is no such thing as "fighting back" when you have 15,000 desperate new grads each year who will take whatever job at whatever salary and working conditions they can get because they have loans to pay off, which cheapens the profession further AND undermines any attempt from the few pharmacists willing to "fight back" to succeed.
I think we talking about two completely different fights. If we implement stronger and stricter laws in place and have a check and balance system to put PBMs in check, we can take the control back.
Red herring argument. First, based on the article you posted the lobbiests are APhA pharmacy orgs, not individual pharmacists - in other words, these are people whose job is to lobby. So a generic "well do something about it" statement is not something that your average joe pharmacist can do even if they wanted to. Second, getting PBMs to reimburse at least the acquisition cost a) will have no impact on job creation or work conditions and b) is not going to net the pharmacy any more money because PBMs will just find other ways to make up that lost profit such as increasing DIR fees. You also have to stop correlating increased reimbursement to increased pharmacist hours - if anything, it will increase pharmacy tech hours since they are the way of the future. This profession is dead. Just accept it.Oral arguments in U.S. Supreme Court PBM case get a new date
The case was filed by Arkansas Attorney General (AG) Leslie Rutledge. PCMA is the professional association that represents PBMs. “This case is one of the most impactful health care cases at the Supreme Court in a decade. That’s why the U.S. Solicitor General encouraged the Court to take this...www.pharmacist.com
I do see deans arguing for that last point and chains employing more pharmacists than I personally deem necessary to "maintain image," but the counterbalance to hiring techs instead of pharmacists is that as an employer you'd get to pay less into unemployment (since you are taxed a flat rate plus % of taxable income of your employees) and you'd be converting current 0-32 houred pharmacists to tech hours 1 for 1 and these positions already don't pay any benefits so I don't see why you'd pay benefits to techs either? The industry standard for pharmacist hours/week worked is somewhere less than what qualifies for full time benefits already, so this is probably a non-issue?
Unless you own a pharmacy or manage an independent, it would be hard to understand why PBMs are the biggest problem our profession is facing.
Because CVS don't own ALL PBMs? haha You think Optum is like "Nah, we'll cut CVS some slack since they're good people"? lol. ALL PBMs are exploiting the loophole since there is ZERO accountability and no check and balance system. No one at this point can audit PBMs. Not even medicare. The law that we are trying to implement is to make sure we can look into their books and see what they're doing. I.e. why or how it that CVS can be reimbursed 1000% more by caremark on the same drug compared to other pharmacies? This is completely illegal in most states. They get away with since there is no agency to keep them on check.
What? I don't know how you're correlating their stock value to PBM abuse.... but i'll try to play... So... maybe they're lowering reimbursements to other pharmacies... because... they're losing money and need to compensate? Again, this should be illegal.
Any proof that it is not?
Very true and I completely agree. It is not a simple solution but its a start. Regulating PBMs can be done right away. Profits can be in the hands of pharmacies, not PBMs starting next year. This will drive hiring of more workers. Heck, I want to hire another part time pharmacist and a tech but can't because these damn PBMs are reimbursing pennies. I'm thankful if we don't get negative reimbursements at this point.
@NorthTexasPharmacist is just a disgruntled retail pharmacist pushing the "PBMs are the devil" narrative because he is directly affected by it so there is personal bias involved in his perception of how the profession of pharmacy works. Poor PBM reimbursements only affects independents, which is why anytime you see lawsuits against PBMs they almost exclusively involve independents/small pharmacy chains. Ever see CVS or Walgreens suing a PBM? I think not. So this is simply a phenomenon of big companies being able to out-negotiate and out-resource smaller companies. In terms of how big a deal poor PBM reimbursements is? Well for one thing PBMs are irrelevant to hospital pharmacy because PBMs manage the pharmacy benefit only and not medical. For another, independents make up 35% of all community pharmacies and retail jobs represent around 70% of all pharmacist jobs so this whole "reform PBMs and it'll fix pharmacy" nonsense will only "benefit" 24.5% of pharmacists while the remaining 75.5% of pharmacists will not benefit from PBM reforms, so it becomes easy to see why nobody cares about PBM reforms except independent owners. And we haven't even established a correlation with increased profits to hiring more staff, let alone hiring more pharmacists specifically. Now, contrast that to closing down schools which 100% of pharmacists in any field will benefit from and stand behind...
Oh the good ol internet insult. You're right. I'm gonna stop this pointless exchange of insults before it gets any uglier. You keep on pushing for your own narrative and agenda. What ever that may be.
Nice deflection. My narrative has been consistent: this is a dead profession. Why would I bother wasting time to fix something that's dead? Do you think journalists care about or are accountable to finding solutions to issues they cover/uncover? No, of course not. Their job is to simply cover the news in as close to an objective way as possible. Same with why I blog on SDN - I don't profit off any this but am doing my part to "spread awareness" about how this is a dying profession.
I don't think it is just the independents going after PBMs. States are suing them for fraudulent claims and isn't it Arkansas that is taking them to the SC?
I'm sure there are other players involved but this is being discussed in the context of "better reimbursements = more pharmacist jobs" - if states get what they want how does that increase the number of pharmacist jobs?
I agree the bigger problem are the con artist schools without a doubt. If we hadn't had the explosion of schools over the past 17 years then we would be in much better shape. But the PBMs are just as shady and need to have their books opened.
The PBM issue will be taken care of eventually due to pharma lobbying power, public perception etc. Pharmacists, on the other hand, need to focus on closing down schools because there are no other market forces/players that will help us in this particular fight. Only thing I can think of is student loan reforms aka if the government stops handing out free money for students to get into $200k+ debt.
Yeap or stop precepting their students
I can't speak for everyone but my goal going to school was to open an independent but looking at the numbers I just can't do it. If I could get more reimbursement, then I would open a place and my old position becomes available. I know a few pharmacy friends that would do the same. I don't want to be a corporate slave but of course who does.
Nope. You do realize it takes business skills and a certain personality to open up your own pharmacy right? You think any pharmacist moms, yes-men let alone 2.0 GPA diploma mill grads will want to open up pharmacies or be successful at it? I think not. Let's not overspeculate... at BEST you might have some chain retail pharmacists leave but not enough to force chains to pay up.
Idk they certainly haven't had any success with whole foods
