How much is enough?
Thursday evening the St. Thomas pharmacists held a public meeting at the Roy L. Schneider Community Hospital to bring their cause to the public.
It appears the V.I. government is forcing the pharmacists to take third-party pay cards for medications, while the third-party payer is reimbursing them less than cost.
In other words, Virgin Islands pharmacists are being forced into being charitable institutions.
The pharmacists brought together a most interesting mix of players in this high-stakes game. There were several representatives of the Legislature, the special assistant to the governor, head of the Insurance Board, representative of the attorney general, commissioner of Health, president of one of the labor unions, president of a major insurance carrier, two representatives of the major third-party payer (PCS) and most of the pharmacists practicing on island.
According to the pharmacists, they are being paid wholesale cost less a percentage plus a small fee. This amount, however, is less than it costs the pharmacist for the medication, supplies and equipment necessary to dispensing, overhead of plant and personnel and government tax.
The insurance company representative claims he was unaware of a problem, and the pharmacists were to negotiate with him at any time. The union rep claims the pharmacists can negotiate with any carrier any time they want to in an attempt to raise reimbursement.
The legislative representative claims the problem is with the negotiated reimbursement rate, not the legislation. The Health commissioner stated he was just there to listen and learn; but went on to claim the right of physicians to dispense drugs if they so desired.
The pharmacists claimed their negotiations resulted in a declaration they could either toe the line, or they would not be reimbursed anything. On the other hand, the pharmacists are being told if they do not have an agreement with a third-party payer for payment, they would have to fill all orders anyway and would not be compensated in any form.
While I am sure we all feel the pharmacists should be able to make some profit to keep them interested in providing the service, there was yet no discussion of scale economies, handling costs between the manufacturer and point of sale, and why the third-party payers felt justified with their stand.
After several hours of spirited discussion, Sen. Allie-Allison Petrus called for a sit-down meeting of key people Feb. 22. Everyone finally agreed this was the only real solution, the key figures agreed to attend and the meeting was adjourned.
I hope that in the near future I will get my full prescription for 90 days locally and will not have to go off-island for my medications.
