Q&A: Life after the NCPA
After a distinguished, eight-and-a-half-year tenure as chief of the National Community Pharmacists Association, Bruce Roberts, independent pharmacy’s toughest champion, retired June 25 as NCPA’s EVP and CEO. He now is president and CEO of Benecard Services, a small pharmacy benefit manager and prescription benefit facilitator firm founded by pharmacist Richard Ullman. Roberts, a longtime former independent pharmacy owner in Leesburg, Va., brought energy and passion to his role and helped spur a resurgence, both for the organization and independent pharmacy. Under his leadership, the NCPA gained stature as a major lobbying force on Capitol Hill, won a series of key legislative victories, reversed a membership decline, renewed interest in pharmacy ownership among pharmacy graduates and built strong collaborative ties with other pharmacy and health organizations. In an exclusive interview with Drug Store News, Roberts looked back on his years with the NCPA and shared his vision for pharmacy’s future.
Drug Store News: Now that you’ve capped this phase of your career, what are your immediate plans?
Bruce Roberts: I’m going to move back to Leesburg, Va. In my new position, I’m going to open a Washington, D.C., office and stay in the area.
DSN: Can you tell us about your new position?
Roberts: Richard [Ullman] wants to do two things: One is to create a new means to manage the prescription drug benefit that is more aligned with the beneficiary and the payer. And secondly, he’s a pharmacist, and his pitch to me is, “I want to do something to not only save the profession, but [also] really position the profession in a very favorable light in our healthcare system.”
Those have been focuses of mine from day one. As you know, I’ve been a huge critic of the PBM industry, and it probably seems very strange that I’m going over to the PBM industry. But I see it as a logical next step of my work. I came to NCPA focused on making a difference and positioning the industry in a very positive light. Benecard is a fairly small company, with about 300,000 lives and about 300 employees, so it’s an opportunity to make a difference.
DSN: How have things changed at NCPA over the years, and what do you see as the most significant accomplishments, both from the standpoint of your own satisfaction and that of NCPA and community pharmacy?
Roberts: I think we’ve made substantial gains over the last nine years. And one of the most significant gains has been fostering a rejuvenated interest in independent ownership.
When I came to the NCPA, there was very little interest in it. Independents’ numbers were dwindling, and there were very few new pharmacies opening. So that’s been a significant change, because now there’s a tremendous interest in independent ownership. We’re opening up about 100 new pharmacies a month, and NCPA’s membership is increasing about 10% a year on average.
The other thing I think where we’ve really made a difference is the increased influence of pharmacists in the political process. We have one of the largest [political action committees] in the country, and a legislative defense fund that’s second to none in pharmacy circles. And we’ve gone from a staff of basically two folks in the political communications area to…as many as 30 people focused in that area.
The NCPA also has become a very strong organization. It’s on solid financial footing, our budget’s increased dramatically, we have more than twice as many staff as when I came here and our membership, having gone through many years of decline, has shown consistent increases.
DSN: What would you like to see accomplished at NCPA over the next couple of years?
Roberts: One place where we haven’t made as many inroads as I’d like is moving to a future where the pharmacist is more an integral part of the healthcare delivery system. That’s one reason for this new gig: It’s going to give me an opportunity to build an engaged network of pharmacists, and to really shake up how the prescription drug benefit is managed. Ultimately, that’s going to be key to that future.
DSN: There’s been a sea of change in Congress’ perception of independent pharmacy. In terms of legislation, what do you see as high points over the last few years?
Roberts: We’ve had a number of wins. Things like prompt pay, inclusion of medication therapy management throughout healthcare reform, the durable medical equipment accreditation issue, the [average manufacturer price] fix [for Medicaid-paid generic drugs]. We really got more in healthcare reform than any other healthcare organization.
I’m not going to begin to take all the credit for that, but I think NCPA had a huge influence on those wins. And the reason was [that] we made a concerted effort to give independent pharmacy…a voice. We took a very methodical approach, building our [political action committee], setting up our legislative defense fund, hosting lawmakers for pharmacy visits, etc. And that has paid huge dividends and culminated in a string of legislative victories.
DSN: It’s also been an era of increasing collaboration with chain pharmacy and other groups, including those outside of pharmacy that are concerned with health issues. Will that trend continue?
Roberts: I think to have an effective trade organization, if you’re not collaborating with the rest of the folks in your industry, you’re making a huge mistake. The devils-and-angels approach doesn’t work.
DSN: Any predictions for when your successor will be found?
Roberts: I doubt there will be anybody in place before October, and it’s more likely to be the first of the year. Doug Hoey, who’s been my No. 2 for many years, is going to take the interim position. He will do a fine job running the organization, and I’ll be there to counsel him as issues arise. I’m committed to remaining active in pharmacy circles.
DSN: Do you still have a financial interest in your own pharmacy?
Roberts: No. Last August I made the decision to sell my last two stores to my employees. So I’m no longer a pharmacy owner, which after 35 years is a little strange.
DSN: If you look out five or 10 years, where would you like to see independent pharmacy?
Roberts: My vision for the industry and the profession is that pharmacists will play a highly integrated role in our healthcare system. Pharmacists will be relied on to take ownership of medication outcomes, and to work collaboratively with the rest of the healthcare team to ensure that prescription drugs are used correctly and you get the desired outcome. That’s my focus, and I have every reason to believe NCPA’s focus will remain the same.
CMPI survey: Alcohol, marijuana biggest substance problems among teens
NEW YORK The Center for Medicine in the Public Interest on Thursday released the results of a national Teen Substance Abuse survey, indicating that police officers and high school teachers nationwide believe alcohol and marijuana are the most serious problem substances facing teenagers.
The results were released one week prior to a Sept. 14 Food and Drug Administration Advisory Committee meeting called to discuss whether or not additional sales restrictions need to be placed on dextromethorphan, a popular cold remedy ingredient that has been associated with teenage drug abuse. According to the survey, police and teachers polled do not believe it is a good idea to force Americans to visit a doctor to get a prescription to purchase commonly-sold cough-cold medicines.
When asked which substances do pose the greatest negative impact on teens, teachers and police identified marijuana and alcohol, followed by methamphetamine and cocaine. More than 1-in-4 police officers (27%) identified prescription drugs acquired by teens as having the greatest negative impact on teens, as compared with 15% of teachers. Nonprescription medicines were named by 1% of police officers as having the greatest negative impact; 2% of teachers identified over-the-counter medicines as such.
The survey also revealed that by a margin of 2-to-1, police officers and high school teachers support education efforts as a means to address abuse of OTC cough-and-cold medicines, versus restricted accessibility to consumers.
“Americans expect to be able to buy cough medicines conveniently at the supermarket or their neighborhood corner store,” stated CMPI VP Robert Goldberg. “Overly restricting access to cough-and-cold products containing dextromethorphan will create more health problems than it will solve, especially during cold-and-flu seasons. We need to find common sense solutions and invest more resources in education.”
Appeals court upholds decision to OK ‘pay-for-delay’ deals
NEW YORK The federal government got a kick in the face Thursday as an appeals court ruled in favor of patent litigation settlements between branded and generic drug companies.
The U.S. Second Circuit Court of Appeals in New York decided not to reconsider a ruling it made earlier this year in the case of Arkansas Carpenters Health and Welfare Fund vs. Bayer AG. The case concerned the legality of a settlement between Bayer and Teva Pharmaceutical Industries subsidiary Barr Labs over the anthrax treatment Cipro (ciprofloxacin), but the court ruled that the deal between the two companies did not violate antitrust laws.
The appeals court’s decision is a major setback for the efforts of the Federal Trade Commission and members of Congress who have sought to ban such settlements.
In most cases, a generic drug company that wishes to market its version of a drug before the branded drug company’s patents expire will file an approval application with the Food and Drug Administration with a paragraph IV certification, a legal assertion that the patents covering the branded drug are invalid, unenforceable or won’t be infringed by the generic drug. In response, the branded drug company usually will sue, but cases frequently result in settlements whereby the generic drug company agrees to hold off launching its drug in exchange for payment of some sort by the branded drug company.
This often comes in the form of an agreement not to use an authorized generic, essentially the branded drug marketed under its generic name, to compete with the generic drug company during its customary six-month market exclusivity period. Legally, the generic company must launch before the patents expire or as soon as they do, and delaying launch after patent expiry would be illegal, though critics such as the FTC and The New York Times’ editorial board have often derided the settlements as “pay-for-delay” deals, with the FTC contending that they cost consumers billions of dollars a year. Nevertheless, most cases that are settled result in launch of the generic drug ahead of patent expiry. In the case of Bayer and Barr, Bayer paid Barr $400 million to hold off launching its version of Cipro.
“Patents, issued by the government, are given the presumption of validity,” read a statement from the Generic Pharmaceutical Association, the generic drug industry’s main lobby. “Any market entry of a generic drug before the brand patent expires –– whether as the result of a finding that the generic product does not infringe the patent, that the patent is not enforceable or through a patent settlement agreement with the brand company –– is a positive, cost-saving event for consumers.”