Persistence Pays Off: Pharmacists in Government Affairs

Ms. Farley is a freelance medical writer based in Wakefield, Rhode Island.

With the upcoming presidential election, change in legislation is inevitable. Staying on top of those changes is vital in any industry, but never more so than in the pharmacy industry. New bills can affect the way pharmacies do business and the way pharmacists provide patient care. Legislators need to make informed decisions on what is best for their constituents when it comes to pharmacy, which is why they rely on pharmacists to educate them on the technical and clinical topics. a position in government affairs gives pharmacists the ability to influence the legislative process and make changes.

At Rite Aid, the third largest pharmacy chain, John Coster, RPh, PhD, serves as the vice president of federal affairs and public policy. He became involved in government affairs while in pharmacy school, where he was active with the American Pharmacists Association Academy of Student Pharmacists and later became its president. That experience inspired an interest in politics and government. At Rite Aid, Coster is responsible for policy issues related to federal health care, such as FDA issues, Medicare and Medicaid coverage, and payment for prescriptions and durable medical equipment, as well as federal policy relating to patient information.

An important part of his job is maintaining a relationship with members of Congress and regulatory agencies in an effort to help formulate public policy. According to Coster, he "makes recommendations to Congress and helps make and promote legislation to help us better serve our patients. This includes drafting comments for legislation and helping members of Congress understand the issues. You are trying to promote or stop legislation; it depends on the bill."

"Our overall goal is to make sure we have strong viable pharmacy infrastructure and to ensure that we can provide high-quality care," says Coster. He says policymakers are becoming more sensitive to pharmacists and the role they play in health care. They are recognizing that pharmacists can have a tremendous impact on patients and health care spending. One of the ways to do this is by encouraging medication adherence in order to keep patients out of hospitals.

From a business angle, Coster's efforts pay off by helping Rite Aid operate more efficiently. "We need to make sure that the government does not put barriers in place to make it more difficult to operate."

One issue that Coster was involved with was the implementation of tamper-resistant prescription pads. "Lastyear, Congress was going to require that all Medicaid prescriptions be written on tamper-resistant pads. It wasdetermined that it would have an effect on future administrative issues, and we were able to persuade Congress to push back the start date from October 2007 to April 2008, so that we could have more time to meet that challenge and educate our employees."

Debbie Garza, RPh

At the nation's largest drugstore chain is Debbie Garza, RPh, divisional vice president of government andcommunity relations for Walgreens. She is currently splitting her time between her office in Washington, DC,and the corporate office in Deerfield, Illinois. Garza graduated from the University of Texas at Austin andspent 8 years as the district pharmacy supervisor for Walgreens in Austin and was the company's state liaison with the Texas Federation of Drug Stores and the Board of Pharmacy.

Like Coster, some of the big issues Garza deals with include national reimbursement metrics and how pharmacists are paid for services. She accomplishes her goals by maintaining vital relationships with legislators.

She says it is important to keep up relationships with legislators as one would with any social relationship. "Talk about issues that are important to them and their constituents. Do not always have a hand out. Invite them to one of your wellness days or to your pharmacy. When you do need their help on something that could be harmful to your profession or pharmacy, you already have that relationship."

As legislators change, it is important to be aware of who is in the majority, who is in the minority, andwhat their positions are on health care and pharmacy issues. "Look at their track record on legislation.Build relationships on both sides of the aisle. Talk to them about taking care of their constituents."

Besides stopping a bill that is deemed harmful or winning a fight for legislation that will help theindustry, Garza says it is important to also consider compromises and how to amend legislation that mightbe harmful. "Half a loaf is better than none. There is always some middle ground. Compromise when youcan." But, ultimately, she says, "You have to do what is right for your company or your profession."

"You rarely get everything you want. Do not get discouraged—it is a process," advises Garza.

Tips on Getting Involved in

Government Affairs

• Take a government class to understand how the process works
• Be active. Register to vote. Vote. Speak up at candidate forums. Help with campaigns.
• Learn about the issues
• Be involved in student organizations
• Contact your legislators to learn what is happening in Congress
• Be involved with local pharmacy associations
• Be involved in lobby days
• Be personable, passionate, enthusiastic, and a good communicator and consensus builder
• Just do it. Make it part of your process instead of just a once-a-year activity.
• Sign up to be a pharmacy advocate on the NACDS Advocacy Action Center at www.capitolconnect.com/nacds