The owner of a small Tallahassee pharmacy wonders about the need for large corporate involvement in his business
WFSU Public Media has been talking with the people who own and operate Tallahassee’s small, independent drug stores. In the fourth of our series of reports, we spoke with the proprietor of the CareRX Pharmacy at the corner of East Tennessee and Magnolia Drive.
What had been a corner gas station is now a small independent drug store. And since early 2017, Harsh Patel has been the guy in charge. He said among the major factors helping him compete with the big national chains, are the big national chains themselves.
“They keep us in business in a way, because whatever they don’t do makes a lot of people mad and they come to us and we take care of them.”
And while the big chain drug stores are quick to claim their vast buying power lets them charge lower prices, Patel insists that’s not quite true. He said corporate profit requirements compel those pharmacies to actually drop some of their less popular medications when supplier prices go up as they inevitably do.
“If they buy if for 50 cents, they’re not going to buy it from some other wholesaler for $1.00. But I could care less. I might normally be buying it at 95 cents and the new supply is $1.20. I could care less! I take care of my patients. It might cost be a little more, but I take care of my patents and move on.”
Part of that customer care, says Patel, includes passing along the savings from medicine manufacturers. He said those companies often issue discount coupons that most chain pharmacies don’t share with customers that could lower - or even do away with - their co-pays.
“A $60 State of Florida patient could do down to $5 for a 90-day supply with a coupon. So it’s a $55 savings and most people don’t even know about it So we save the patient $55 and the hassle of standing in line at CVS sometimes 20 minutes to pick up the prescription.”
And, like the other independent drug store folks we’ve contacted, Patel railed at the impact of the PBMs, pharmacy benefit management companies. He said they greatly increase the cost and aggravation of doing business for small independent drug store operators like him and cited a recent questionnaire he received from the PBM known as CVS/Caremark.
“If I don’t do it, they will kick us out of the network. Every prescription I fill, they would charge us a $1.00 fee just to be part of the network. So right now, they charge us around 20 or 25 cents per prescription when we submit the claim. But if I didn’t do the questionnaire, would have been $1.00. But it’s part of the deal; you gotta do what you gotta do.”
Besides the added expense and complication the PBMs impose on his business, Patel also questioned their actual purpose and what value they add to the business equation.
“CVS/Caremark is pretty much the biggest one for Tallahassee. The second biggest one is Prime Therapeutics. Prime Therapeutics and Florida Blue, they work the same way behind the scenes and are owned by Express Scripts. Express Scripts and Cigna, they’re the same company now and their parent company is New York Life. So it’s a long tale, but if you really follow it, big corporations own these small things.”
And on top of it all, Patel lamented the ever-growing need for drug stores across the board to spend more and more of their time and resources simply cranking out thick reams of paperwork.
“The insurance companies do not pay what they used to pay, so they cut back on the labor. The number of people available to fill out our prescriptions, it’s going down every year. So it’s putting too much pressure on all the pharmacists throughout the nation. It doesn’t matter; independent pharmacy owners or chain pharmacists. And sometimes it’s just too stressful to keep up with it. But at the end of the day, if I make a difference in somebody’s life, it’s worth it!”
Throughout this series, we've found a few concerns common to the Capital City's small, independently owned drug stores. One of these is what they say are the extra costs and aggravation imposed by the aforementioned pharmacy benefit management firms. We'll get further into that topic in our next report.