Yesterday I attended the biggest pharmacy conference I’ve ever been to – APhA’s annual conference with around 6,000 attendees.  This year it happened to be in my home city, San Francisco, and I decided to take advantage and do a short presentation on the PBM updates during the Pharmacy Planning Services’ (PPSI) breakfast. In a nutshell, we discussed efforts to push for legislation to eliminate all retroactive DIR fees or any other price concessions; (2) a new California bill (prepared by CPhA) to require PBMs to be licensed as pharmacies! (Georgia is the only other state that requires PBMs to be licensed by the Board of Pharmacy); and (3) I discussed some recent suits filed by pharmacies against PBMs.

I also met a representative from American College of Apothecary (Donnie Calhoun) and we engaged in an interesting discussion about how we can better advocate for appropriate reimbursement amid the changes to the ACA proposed by president Trump. It is undisputed that pharmacies are playing more and more important role in coordinating healthcare, MTMs, and providing necessary healthcare services through extended scope of practice – it seems too much to handle for a pharmacist. Donnie’s point was that pharmacists must choose which route to take: dispensing medications or promoting wellness (MTMs) – but not combining the two. I totally see the point, this also could lead to developing a niche in the pharmaceutical market and increasing the return on investment. In addition, current PBM practices encourage more and more pharmacists to enter clinical work and provide more wellness programs, while letting chains and PBMs do all the dispensing. The time of change is here!