Pharmacy update from Darius Randeria Darius RanderiaHappy New Year to all you fellow Pharmacists as well as all of the hard-working office staff at the new AHS PharmStat headquarters.  For many years, as the President of PharmStat, I used to enjoy giving an annual update. I used to combine my observations of trends in Pharmacy staffing, important changes to practice as well as a general business update. The business aspect has been gladly relinquished to those more able than I but I wanted to take this opportunity to reach out to all of you with some ideas for the New Year. 2013 was a year full of turmoil for many in the Healthcare arena. For many, it was the preparation for changes to come rather than significant disruptions during the year. The Affordable Healthcare Act was rolled out before it was ready and many were left unable to enroll. A surge in December enrollments left many uncertain as to whether their new “Marketplace”, plan selection had actually been implemented by the respective insurance company or whether their old coverage had terminated. This turmoil is particularly evident this month as the number of insurance rejections and unexpected deductibles has soared. In many respects, we, as Pharmacists, are the final part of the mechanism. It is unfortunate that we often receive the fallout when, in reality, there is little that we can do to determine the price of a covered drug. There is, unfortunately, a large population of the general public that does not fully understand their coverage at the best of times, so changes only compound the difficulty. It is easy to get frustrated but we need to remember that things that are obvious to us are not obvious to others. To give an analogy, I fly home to the U.K.  frequently and I have noticed a gradual decline in Customer Service with the airline that I have used for twenty years. As a flight attendant, the most stressful part of your shift is the first fifteen minutes as a large group of people tries to assemble itself in to a much smaller space while all the time hoping to carry all their luggage with them on board. I have noticed members of the cabin shaking their heads and recently one that said to an elderly gentleman, “Do you really think that is going to fit?” She then turned to her colleague and said, “It’s not rocket science, is it?” I mention this example because the attendant obviously assumed that this gentleman dealt with the hand luggage issue every day just like she did. However, he may not have flown in ten years or it might be his first flight ever. I commiserate with them in some respects but you simply have to give people the benefit of the doubt. The same is true in the pharmacy, especially when we have a recurrent problem that seems to consume our whole day. That being said, knowledge is power. If I have to spend time switching a patient to a different drug that is on formulary, I let them know that they need to print a copy of that formulary and take it to the Doctor every time. If the patient is surprised by their co-pay, rather than just telling them that it is their insurance company and not us that is the problem, I tell them to check with their insurance company when they get home and if there are any discrepancies, we will be glad to take care of it immediately. That puts the onus on them to access their own information. In general terms, the AHA will most likely increase the number of insured individuals and I believe that we will see an increase in prescription volume. Unfortunately, with reimbursements being set so low and with some companies starting to waive co-pays for certain plans, it will be a tough year for our independent brethren as they lose some of those cash prescriptions that they could still undercut. Regardless of your political tendencies, it is a big change and it will require some time to judge its merits or lack thereof. Healthcare financing is a very complex problem. You will never hear anything other than “Elevator Talk”, from the mainstream media. It is a problem with thousands of interrelated variables that would take many days to even briefly examine. On another note, I hope that we, as Pharmacists, can do a better job of explaining what we do to Washington, our Physicians and our patients. We control the most expensive component of healthcare, the drugs. We are in a unique position to take cost out of system and, unless some cost is abated, healthcare prices will continue to rise regardless of who is footing the final bill. We have to market that as a group! I hope you all have a wonderful year. Darius Randeria R.Ph Pharmacist