PHI: We want to work with CHCC

Pacific Health Inc. Pharmacy, better known as PHI Pharmacy, made clear in an interview with Saipan Tribune that all it wishes to do is “work with [the Commonwealth Healthcare Corp.] and make it easy for the pharmacy to remain open within the Commonwealth Health Center without interruption.”

The recent dustup between PHI Pharmacy and CHCC over the control of the pharmacy within the hospital—called an outpatient pharmacy—has resulted in patients, hospital officials and employees, and even politicians weighing in on the pros and cons of having a pharmacy in the hospital.

PHI Pharmacy vice president Bruce Cohen said in a long distance phone call with Saipan Tribune that PHI has been able to “rectify the situation,” referring to the Commonwealth Health Center’s previous inability to maintain stocks of certain medicines.

“In 21 year we’ve never had problems. We stayed open through Typhoon Soudelor and we have been offering a 365-days-a-year service, making access to prescription drugs easy for people,” said Cohen.

In an earlier interview with CHCC chief executive officer Esther Muña, she cited four benefits of an outpatient pharmacy controlled by CHCC: the reduction of costs in medicine, increased quality of care for patients, potential profit for the hospital, and Centers for Medicare/Medicaid Services compliance.

Also, CHCC participating in the 340B drug program, Muña said, is a way to secure significantly cheaper prescription medicine.

The 340B drug discount program is a federal government program established back in 1992 that requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered facilities at significantly reduced pricing.

Cohen said the program, however, does not include independent pharmacies.

For 340B pricing to be utilized by a pharmacy, the pharmacy first has to be a “contract pharmacy to a facility that is eligible and approved by the 340B pricing program,” Cohen said.

That means that as long as CHC is eligible to participate in the 340B program and as long as PHI Pharmacy has a contract with CHC, PHI is also eligible to participate in the 340B program alongside the hospital.

CHC has yet to be deemed eligible to participate in the 340B pricing program.

“PHI has approached CHC and said we would be a contract pharmacy using 340B medications and participate along with CHC in the program,” he said.

“We have an established pharmacy, we have all the insurance companies online, we have the inventory, staff, computer systems, and everything that is necessary to make this transition very easy for CHC,” he said.

Cohen also pointed out that if CHC chooses to operate its own outpatient pharmacy, the estimated time of approval for the hospital’s eligibility to participate in the 340B program would be in late August this year. Also, the construction of a new outpatient pharmacy may take a while, he said.

These possible avenues of delay could mean the hospital would be without a pharmacy for more than a month, Cohen said.

Cohen believes that PHI has been providing patients adequate “access to pharmaceuticals.”

“We have adequate inventory, staff, and availability. We work with the physicians of CHC. We partake in several meetings that the hospital has for continuity of care. We’re constantly working with physicians. I don’t really see how that can be improved,” he said, adding that the sharing of patient information through electronic health records, or EHRs, as Muña had cited, takes too long.

“…It is so much quicker to make a phone call to a doctor. The doctors are right there. In retail pharmacy, outpatient pharmacy, people want to get their prescriptions as soon as they can. Over half the time, the person is not going to come back or wait,” he said.

PHI prices follow insurance companies
Contrary to popular belief, Cohen said, the prices of pharmacies are dependent on health insurance companies. He said the insurance company hires a pharmacy benefit manager that designs the reimbursement for pharmacies using average wholesale prices and other different pricing schemes plus a dispensing fee.

“They send a contract to the pharmacy—even doctors, radiology labs, and other healthcare services—to either accept the deal the insurance company is offering and participate in the program or not. Pharmacies don’t set the price for prescription drugs, the insurance companies do,” he explained.

Team player
Cohen said the bottom line is that there is access to pharmaceuticals at the hospital. He said PHI is not “against CHC [taking over] the outpatient pharmacy.” He would rather have PHI and CHC working together to maintain the pharmacy “without interruption.”

“This is an opportunity to work as a team and solve this situation that isn’t really a problem,” said Cohen. “If PHI is asked leave this Aug. 14 and a pharmacy doesn’t open until next year, that would be a dreadful public health crisis with lack of public prescription drugs, particularly at the hospital,” he added.

“If we are asked to leave, we are asked to leave, but do we want to close PHI and have nothing to open in its place? I don’t think so,” he said.