Friday, March 26, 2010

Bruce Roberts to Leave NCPA, Embrace Mail Order

From yesterday's press release NCPA's Bruce Roberts to Conclude Tenure as CEO in June:
“The National Community Pharmacists Association (NCPA) today announced that Bruce T. Roberts, RPh, has decided to conclude his eight-year tenure as Executive Vice President and CEO on June 25, 2010...Roberts will join BeneCard PBF as President and CEO.”
Let me give credit where credit is due. Mr. Roberts has accomplished a lot during his tenure at NCPA, most notably his work in boosting the pharmacy industry’s influence in Washington, DC. The NCPA’s advocacy ensured that the new health care reform bills included many policies favorable to the retail pharmacy industry.

BeneCard PBF appears to focus on pass-through PBM contracts, although it’s a fairly small player right now. According to the most recent Pharmacy Benefit Trends and Data Report, BeneCard has 160 clients, covers 250,000 lives, and gets 80% of its business from the public sector.

But I am curious about a subsidiary called Benecard Central Fill, a prescription mail service pharmacy. I’ll be interested to see how the company’s strategy changes given Mr. Roberts previous statements about mail order. Here’s a sampling of his thoughts on mail:
  • "When patients use mail order they lose the face-to-face relationship that occurs inside their community pharmacies with clinically trained health care professionals who are dedicated to promoting safety and improving health outcomes.” (source)

  • "Mail order programs claim to provide patients greater convenience and lower cost. In fact, patients say they have to wait too long for their drugs and some are paying twice for them.” (source)

  • "Deliveries can be delayed, sent to the wrong address, or damaged. Patients consistently complain to community pharmacists about having to do without their medication due to late mail order delivery.” (source)

  • "Further, mail order is touted as a way to ensure patients stick with their medication therapy. But if deliveries arrive too late or are compromised, patient adherence is severely undermined, not encouraged.” (source)
In the meantime, I expect that NCPA will tone down its rhetoric about mail order pharmacies, easing some of the political pressure on PBMs such as CVS Caremark (CVS), Express Scripts (ESRX), and Medco Health Solutions (MHS).

And to the many folks who emailed the news to me...No, I will not be applying for the job.


  1. Thank you for posting this. I speak from first hand experience when I say that while mail order does have its own unique challenges, my independent mail order specialty pharmacist is a VITAL part of my health care team.

  2. Man, you are too funny!

    Good point, though.

  3. On a rainy, cold Friday morning, this post today had me cracking up. Will be interested to see the response you get from that one…

  4. Very niiiice.

    Adam, loving that Borat sense of humor!

    Keep up the good work.

    Me? I'm still work'n for the big guys, but soon to be shifting to Taco Bell.

  5. Hmmm, a Borat sense of humor, you say?

    Drug Channels: Economics Learnings of Pharmacy for Make Benefit Glorious Nation of US and A

  6. There are very distinct differences in mail order vs central fill. MO being a core tool used by the PBMs with employer driven incentives that nearly manadate the use of MO for beneficiaries.
    Central Fill however is by definition a hybrid. The script typically is entered into the system at the retail setting (unless called in) and electronically transfered to a CF operation where using the efficieny and automation of a MO the rx is assembled and physically returned to the retail/community setting. The patient has a continuous relationship with their community pharmacy and the CF is transparent to them. This only work for non-acute processes similar to MO. While a couple of chains have deployed this on a stand alone basis McKesson and ABC have been doing this for years with customers such as Longs and Safeway etc. Here the efficiency of having trucks deliver the the day to day meds are captured by locating a CF plant near a DC and the truck picks up the completed rxs to deliver to the store. It took a while for the boards of pharmacy to figure this out and the action of filling an rx vs dispensing had to be worked out. The community pharmacy does the dispesing and that is how from a billing perspective to the PBM the transaction looks like. Independants whose volume may increase to a point of having to hire a pharmacist can benefit through CF and automation and hold off doing so. Takes a ton of IT coordination and training the patient but IVR and other technologies are making these enhancements and most patients don't know the difference...Just call a modern you ever get the pharmacist right away? Rarely....the IVR pushes the patient on refills to delay coming in and this delay facilitates the use of CF....tricky and smart....

  7. This is a pretty snide posting, Adam - definitely not worthy of you. Having known Bruce over the years, I would anticipate that he would use his influence and position to address the issues mentioned in the quotes you provided.

  8. I liked your calling bruce roberts' out on the mail issue today! You sure are stirring it up with the pharmacists lately.

  9. I believe that Bruce knows what he is doing for the future of Pharmacy and is working to create a viable option for all, one that is Independent of PBM's, one that is fair, just and right, not only for our business, but for our PATIENTS! I believe Bruce is about doing things the right way, for the right reason, not the wrong way for the right reason!

    Mandatory mail order is not an acceptable practice of Pharmacy. It takes away patient choice and all the elements of clinical practice that Bruce speaks about and we live! It is unfair and not just. As an independent, I can counsel a patient and maintain a relationship and still put the prescription in the mail. This is not the complaint!

    When Pharmacist's are locked out of participation, and the PBM owns the Pharmacy of sole choice, like with Health America or Coventry, in Pennsylvania, the Patient suffers and those of us Pharmacists, on the front lines of patient care struggle to watch our patients suffer! To the point of refusing to take life sustaining medications because they have no faith in mandatory mail order and their choice is gone! Make it better Bruce is what I have to say! Go for it! Sorry Alan, you are out of line here! Come to the front lines of pharmacy practice!

  10. To Mr. Anonymous...a couple posts up,

    Nice job on detailing the diff b/w central fill and mail order. Plenty of folks following this blog I bet had no idea.

  11. I thought this was an April Fools post early.

  12. Re: Central Fill

    The Benecard website states: "Benecard Central Fill, L.L.C. is our state-of-the-art prescription mail service pharmacy ..." (emphasis added)


  13. At first I thought the “Embrace Mail Order” headline was an early April Fool’s, but the article is awesome. But, thinking of all the intemperate things I’ve said in my (long) life, I fear that someday there will be a blog where I have to eat my words, too. HA!

  14. Adam,

    It's time to put on the old thinking cap.

    With April 1 around the corner, probably another opportunity for the WAG-WMT merger post.