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Business, policy, politics converge at NACDS

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BOSTON — Telling pharmacy’s story to the public and to policy makers is a long-standing priority of the National Association of Chain Drug Stores, so it’s no surprise that the organization used its 2016 Total Store Expo (TSE) here this month to update its message.

The story that pharmacy professionals need to be telling is that they “can ultimately make a tremendous difference on issues that are posing significant challenges to our country,” said NACDS chairman Martin Otto, chief merchant and chief financial officer of H-E-B.

“We need improved access to quality, affordable health care, which pharmacy can help to provide,” Otto said. “Health care spending is crowding out social services and education dollars. As a result, poverty is increasing, creating a vicious cycle. The good news is that there are solutions, and we can collectively lead the way.”

Retail pharmacies are often the most readily accessible health care provider, according to NACDS, which notes that nearly 90% of Americans live within five miles of such a business, and that these businesses are uniquely positioned to provide access to medications and cost-effective health services such as immunizations and disease screenings.

Otto sees three essential roles for NACDS: create a marketplace for suppliers and retailers to get together; advocate on behalf of pharmacy; and participate actively in public policy ­solutions.

The nation’s current policies produce some unsettling differences in how the United States spends on health care compared to other wealthy countries, Otto said. Spending on health care accounts for nearly one-fifth of the U.S. economy, as measured by gross domestic product, he said. In countries such as Finland and Germany, health care accounts for 8% to 11% of GDP.

“So on health care we’re spending a lot of money, and the question I think we have to ask is are we getting our money’s worth? The answer is no,” Otto said. American’s life expectancy at birth is shorter than in other developed countries, and infant mortality per thousand lives in the United States is greater than in any other developed country. “We spend over $9,000 per person on health care. The other countries are spending typically between $4,000 and $6,000.”

So why the bad results despite the higher spending? Otto sees three reasons: “One is poor individual health knowledge and behavior; the second is limited patient access and time with health care providers; and then the third is a host of structural problems,” including the way providers are incentivized around volume and speed rather than around quality of care and wellness, and the dearth of standardized electronic health records.

The experience of other developed countries shows that the problems can be overcome, said Otto. He urged TSE attendees to encourage politicians to “think in a systems perspective about this.”

“We need long-term, end-to-end thinking about health care, its connection to other spending needs, and how individual actions affect the overall system,” Otto said.

In his opening remarks, NACDS president and chief executive officer Steve Anderson touted actions that the industry has taken to influence the role that health care plays in American society.

“NACDS is helping to put the public back into public policy,” Anderson told TSE attendees. “NACDS is putting patients at the center of patient care. NACDS is keeping the membership at the heart of member service. NACDS is injecting the pharmacy electorate into critical elections. And the NACDS Foundation and our partners are focusing on the public in public health initiatives.”

NACDS and trade associations occupy an important place in society, he said, “at the nexus of where business, policy and politics come together.” And with national elections coming in November, the pharmacy industry has another chance to help shape public policy.

“Ten years ago we weren’t winning a lot of public policy victories,” Anderson said. “Members of Congress viewed our members as retailers that sold drugs in addition to many different products that are found in our stores, but they never really viewed us as part of the health care delivery system. So the board of directors said that we were going to revitalize NACDS and move in a different direction, that we were going to put the public back in public policy. And we do that really in everything we do.”