In the Wake of Part D, A Big Thank-You

It is time to say thanks to all of youwho have worked so hard to helppeople through the painful transitionto Medicare Part D Prescription Drugplans. It is largely due to the work of dedicatedpharmacists that many thousandsof people have continued to receive theirmedications despite a system in chaos.

When introducing a program of such anunprecedented scale, some problems areinevitable. Many of the issues, however,stemmed directly from the approachtaken by the companies responsible forthe new prescription plans.

First, insurers and pharmacy benefitmanagers (PBMs) were very poorly preparedfor the surge in call volume. SomePBMs apparently were so swamped thattheir representatives could not answerthe phone at all; in other cases, waittimes stretched out to an hour or more.As a result, dedicated pharmacists andtechnicians sometimes spent entire daystrying, and sometimes failing, to help justa tiny handful of people. For some, theprocess got a little smoother as theweeks went by, and the Centers forMedicare & Medicaid Services, and thenthe insurers, gradually worked out someof the problems.

That was not the only issue, however.Tohelp people desperately in need of medications,some pharmacists provideddrugs, more or less free, even when theywere not able to reach PBMs and insurersto verify that the people were covered.Perhaps even more pharmacists wouldhave been prepared to hand out drugsworth hundreds of dollars if they had beenmore confident that PBMs would protectthem by reimbursing them. Unfortunately,many pharmacists do not trust PBMs.

Even in cases where they have beenable to reach insurers and verify coverage,some pharmacists have been leftwith an uneasy feeling about reimbursementby overloaded insurers and PBMs.Any delays in reimbursement will hurtpharmacies whose business is alreadysuffering from the extra unpaid work thepharmacists have put in on behalf ofMedicare recipients. Overall, the problemswith Medicare Part D are increasingthe pressure on hard-pressed communitypharmacists who already worry aboutwhether they will able to stay in businessat all. Now is the time for insurers torespond quickly to pharmacists who havedone so much to make the system work.

For now, though, once again, here is abig thank-you to all who have helped peoplethrough this transition—for the countlesshours of extra work, for your commitmentto your customers, for helping keepthe supply lines open. We all know thatpharmacists play a vital, yet underappreciatedrole. Perhaps, as a result of youractions during this health care crisis,more people will come to understand thevalue of the pharmacist.

Mr. Eckel is professor and director ofthe Office of Practice Developmentand Education at the School ofPharmacy, University of NorthCarolina at Chapel Hill.