About 1% of Paulsen’s business comes from compounding custom prescription drug preparations. // Photo by Eric Näslund
In Oregon, independent pharmacies are tackling other political and economic issues with varying degrees of success. The sector scored a big win in 2009 with the creation of a “critical access” pharmacy category under the Oregon Prescription Drug Program, which provides coverage to people without insurance, as well as thousands of teachers through the Oregon Educator Benefits Board. After community pharmacists in rural counties complained the program’s reimbursement rates were too low, Rep. Greg Smith (R-Heppner) helped lobby for the new category, defined as the “sole pharmacy in a community within a 10-mile radius of other pharmacies.” Such pharmacies, including Murray’s Drug in Condon — the only store within a 90-minute drive — receive a higher dispensing fee.
People in rural areas often have to drive 20-30 miles or rely on mail order, says Scott Eklad, director of the Oregon Office of Rural Health. “Particularly for emergent conditions, that is not good health care.” The critical access program, Eklad says, recognizes the value of rural pharmacies and the importance of helping them become financially viable.
The budding “Entrepreneurial Academy” at Oregon State University’s College of Pharmacy is another effort to shore up the struggling sector. The program aims to get a new generation of students excited about working in non-hospital settings, says Courtney, who is helping organize the curriculum. The academy will “focus on the business and marketing knowledge” needed to run a stand-alone pharmacy, instead of working as an employee, Courtney says.
Whether these initiatives will compensate for health care reform efforts is unclear. In January, for example, Oregon adopted a new benchmark for Medicaid pharmacy reimbursement, a move experts agree will lower reimbursement rates and profitability for independent drug stores. Community pharmacists also oppose a bill that would allow physicians’ assistants under certain circumstances to dispense medications, a policy shift favored by one-stop medical and urgent care clinics such as ZoomCare, a Hillsboro-based company. “We want to make sure we’re not being kept out of the loop,” says Courtney.