2022 Board of Directors Election Results

The Elections Committee is pleased to announce that the election to fill positions on the EPIC Pharmacies Board of Directors has concluded. Thanks to all who cast their votes.

Congratulations to the following independent pharmacy owners, including incumbent and new board members.

  • Robert J. McLaughlin, Jr., Realo Discount Drugs
  • Steve Moore, Condo Pharmacy
  • Michael Murphy, Mississippi Discount Drugs
  • Tyler Taylor, St. Louis Hills Pharmacy

EPIC Rx Supports HB 973 in Maryland

March 1, 2022
Chair Pendergrass
CC: House Health and Government Operations Committee
Annapolis, Maryland

Re: Supporting HB 973 – Pharmacy Services Administrative Organizations and Pharmacy Benefits Managers

Dear Chair Pendergrass and Committee:

EPIC Pharmacy Network (EPN), a Pharmacy Services Administrative Organization (PSAO) that has served Maryland independent pharmacies for 30 years, would like to express its support for HB 973.

HB 973 corrects undue logistical burdens imposed by the passage of HB 978 in 2020 on all PSAOs operating in Maryland. EPN is greatly concerned about the burden of HB 978 on our ability to continue operating in Maryland — and without the essential services that we provide to 134 Maryland independent pharmacies, many would not be able to remain open to serve the patients in their communities. We are grateful to the sponsors of HB 978 for introducing HB 973, which would correct some of the most pressing logistical burdens unintentionally caused by the 2020 bill.

Independent pharmacies have worked harder than ever to support Maryland communities through the COVID-19 pandemic. They have administered tests, vaccines, and boosters and provided patients sound medical advice during an otherwise uncertain time. In addition to these pandemic stresses, they face complex administrative pressures that make running a business a challenge. For example, pharmacies must sign and manage many different contracts just to procure medications for their patients and guarantee that insurers will cover patient prescriptions.

For large chain pharmacies, dealing with this red tape is no problem. They have a large, specialized staff that negotiates directly with PBMs. On the other hand, independent pharmacies struggle to manage these relationships and run their small business at the same time. This is why PSAOs exist, to help alleviate these burdens. EPN takes care of the back-office responsibilities and manages complex administrative and operational tasks on their behalf, such as handling the intricacies of claims, contracts, reimbursements, compliance, and credentialing.

Furthermore, EPN does not influence the price of medications or drug benefits. Regulating us like a PBM not only misaligns with our business model and function but will not bring any greater prescription drug price transparency. Instead, the undue burdens placed on PSAOs by HB 978 threaten our ability to operate.

EPN requests that you support HB 973 to enable EPN to continue providing essential support to independent pharmacies and pharmacies to fulfill their primary function: helping keep Maryland communities healthy.

Sincerely,

Brian Hose, PharmD
Chairperson, EPIC Rx Board of Directors
Owner, Sharpsburg Pharmacy, Sharpsburg, MD

EPIC Pharmacies Announces CEO Appointment

EPIC Rx has announced the appointment of Robert J. McLaughlin, Jr., R.Ph., as CEO and president. McLaughlin, who has held the role of interim CEO since April 2021, will lead EPIC Pharmacies Inc., EPIC Pharmacy Network Inc., and PharmCAP LLC.

A proven business leader, McLaughlin brings 23 years of experience as CEO of Realo Discount Drugs. Having opened his first pharmacy in 1998, McLaughlin successfully expanded the pharmacy group to 19 locations.

“The entire EPIC Rx board is confident that Joey’s proven record of business and independent pharmacy success will be a great asset to EPIC Rx,” says Jeff Sherr, P.D., EPIC Pharmacies board member and president of Apple Discount Drugs. “Having served with him on the board for several years, I look forward to the strong leadership he will provide for EPIC Rx and its members.”

EPIC Pharmacies is a member-owned cooperative led by a board of directors comprised of independent pharmacy owners. The organization provides buying group, pharmacy service administration organization (PSAO), and compliance solutions to independent pharmacies across the nation. 

“This is an exciting new challenge for me. I look forward to leading the organization and improving efficiency and returns to our members,” says McLaughlin. “We have already made considerable progress in a short time by centralizing operations at our growing Virginia office and streamlining programs and services,” says McLaughlin.

McLaughlin joined the EPIC Pharmacies board of directors in 2018 as a licensed pharmacist and independent pharmacy owner. He is a member of the National Community Pharmacists Association and North Carolina Association of Pharmacists. He previously served ten years on the North Carolina Board of Pharmacy, including the role of board president. McLaughlin is a graduate of the University of North Carolina at Chapel Hill School of Pharmacy.

What’s Worked at our Pharmacy: A Member’s Perspective on Clinical Services

Anna Baird, PharmD, and Ashley Abode, PharmD, are part of the EPIC Rx Clinical Mentor Program, in which independent pharmacists have graciously offered to share their knowledge and expertise in achieving clinical success with fellow EPIC Rx members. Contact us to learn more.  

“At Realo Discount Drugs, we understand dispensing medications is only part of the story when it comes to patient care. That is why we strive to offer a variety of all-encompassing services to empower our patients and help them thrive. 

“Adherence and access to medication play a big role in keeping health conditions under control. At Realo Discount Drugs, we equip our patients with the tools they need to take their medications correctly on a daily basis by offering medication synchronization or blister packaging. We use a centralized process and automation to provide high-quality blister packs resembling seven-day pill boxes allowing patients to keep their medications organized. Although the process is centralized, it does not eliminate the personal touch provided with this service. Prior to initiating blister packaging, a pharmacist works with each patient or caregiver develop with an appropriate schedule for taking their medications.

“These medications are then synchronized to be filled at the same time each month, minimizing trips to the pharmacy. Blister packaging ensures patients take their medications at the appropriate times and minimizes the burden on the caregiver and patient, who often has difficulty filling their medication boxes. The team ensures patients have access to their medications by offering delivery services and helps patients navigate any medication changes between fills. 

“While having adherence tools is key, we have found that providing education on medications and disease states is essential to driving clinical performance. Realo Discount Drugs has a dedicated team of clinical pharmacists both on and off the counter who complete comprehensive medication reviews with patients to provide disease state and medication counseling, optimize their medication regimen, and improve their health outcomes.

“One platform Realo Discount Drugs utilizes to identify patients who could benefit from an enhanced touch is OutcomesMTM. Additionally, we work with the North Carolina Division of Public Health to provide medication therapy management services to patients with hypertension and hyperlipidemia. This gives pharmacists an opportunity to take a targeted approach to managing cardiovascular disease.

“Realo Discount Drugs is also connected with a local Accountable Care Organization (ACO) to provide chronic care management services. Through this service, pharmacists provide a monthly medication reconciliation, review labs, and communicate directly with providers and other healthcare team members through the electronic health record. Realo Discount Drugs utilizes these platforms and partnerships to identify patients who would benefit from group education in settings like the Diabetes Prevention Program and Diabetes Self-Management Education. The addition of these lifestyle interventions engages patients in their overall health leading to better adherence and outcomes and fuels opportunities for further collaboration with other health team members.”

Anna Baird, PharmD, and Ashley Abode, PharmD
Clinical Pharmacists
Realo Discount Drugs
North Carolina

Board of Directors Election Results

The Elections Committee is pleased to announce that the election to fill positions on the EPIC Pharmacies Board of Directors has concluded. Thanks to all who cast their votes.

Congratulations to the following eight independent pharmacy owners, including incumbent and new board members.

  • Robert Borgatti, Vienna Drug Center – two-year term
  • Justin Boyd, Coleman Pharmacy of Alma – two-year term
  • Jonathan Grider, Lake Cumberland Pharmacies – three-year term
  • Gerard Herpel, Deep Creek Pharmacy – two-year term
  • Brian Hose, Sharpsburg Pharmacy – two-year term
  • Kenneth Reed, Reed’s Pharmacies – three-year term
  • Jeffrey Sherr, Apple Discount Drug Pharmacies – three-year term
  • Stephen Wienner, Mt. Vernon Pharmacies – three-year term

EPIC Pharmacies Announces CEO Departure Effective March

After more than six years of service, Jay Romero will step down in his role as CEO of EPIC Pharmacies, Inc., a national network of independently owned pharmacies, and president of EPIC Pharmacy Network, Inc, a nationwide Pharmacy Services Administration Organization (PSAO), effective March 1, 2021.

“Jay’s work has helped our organization lay the groundwork for what will be a fruitful future. Over the last two years, his work specifically in advocating for fair pharmacy regulations have made a significant impact on the industry,” says Jeff Sherr, P.D., president of the EPIC Pharmacies board of directors and president of Apple Discount Drugs.

Romero has had a long and successful career in independent pharmacy. He was an independent pharmacy owner for more than 10 years and a practicing pharmacist for more than 20 years. Prior to holding his current role, Romero served on the EPIC Pharmacies board of directors and played a key role in advocating for the interests of community pharmacy as chairman of the EPIC PharmPAC of Mississippi.

“Under his leadership, EPIC Pharmacies has been able to advance the solutions and technologies offered to independent pharmacies,” says Mark Barwig, EPIC Pharmacies executive vice president.

For more information about EPIC Pharmacies, visit www.epicrx.com.

EPIC Pharmacy Network Names Bretta Grinsteinner Vice President of Network Development

EPIC Pharmacy Network, Inc. (EPN), the nationwide Pharmacy Services Administration Organization (PSAO), announced today the appointment of Bretta Grinsteinner as vice president of network development.

Grinsteinner will be responsible for negotiating with pharmacy benefit managers (PBMs) and health plans on behalf of independent pharmacy members.

“This last year has presented many upheavals in the pharmacy industry. During this time, we conducted a comprehensive search for an experienced and innovative leader for our PSAO. I am happy to say that we have found an individual with an extensive industry background who can create a strategic path forward for continued EPN success,” says President of EPN Jay Romero.

Grinsteinner brings more than 20 years of experience in managed care and pharmacy network development. She was most recently AVP of network management at Prime Therapeutics, where she played a key role in managing contract negotiations, improving performance measures, and advancing operational efficiencies. 

A wholly owned subsidiary of EPIC Pharmacies formed in 1992, EPIC Pharmacy Network (EPN) provides centralized contracting and administrative services to pharmacy benefit management (PBM) companies, HMOs, and other third-party payers for independent pharmacies across the United States.

EPN President Addresses Supreme Court Ruling and Outlines Next Steps

The Supreme Court of the United States (SCOTUS) ruling in Rutledge v. Pharmaceutical Care Management Association (PCMA), a pharmacy benefit manager (PBM) trade association, is a long-awaited advance in PBM regulations and protecting independent pharmacies.

While the court’s judicial review is crucial to interpreting regulations, only the legislature can create new or amend existing laws.

Currently, the unanimous SCOTUS decision is only applicable to Arkansas regulations; however, it will significantly impact the more than 35 states (including Iowa, Maryland, New Jersey, and Kentucky) with legislation that addresses reimbursement rates and drug prices. The majority and concurrent opinions stated that:   

States can regulate PBMs.

State rate regulations that merely increase costs or alter incentives for Employee Retirement Income Security Act of 1974 (ERISA) plans without forcing plans to adopt any particular scheme of substantive coverage are not pre-empted by ERISA.” – SCOTUS Slip Opinion, Page 2.

Pharmacies can refuse to fill at a loss.

“Allowing pharmacies to decline to dispense a prescription if the PBM’s reimbursement will be less than the pharmacy’s cost of acquisition does not interfere with central matters of plan administration.” – SCOTUS Slip Opinion, Page 2.

Pharmacies refusing to fill at a loss are not denying patient benefits.

“When a pharmacy declines to dispense a prescription, the responsibility lies first with the PBM for offering the pharmacy a below-acquisition reimbursement.” – Justice Sotomayor, Majority Opinion, Page 9.

PBMs make profits in the passthrough.

“A PBM’s reimbursement from a plan often differs from and exceeds a PBM’s reimbursement to a pharmacy. That difference generates a profit for PBMs.” – Justice Sotomayor, Majority Opinion, Page 2.

At EPIC Rx, we are evaluating existing PBM regulations with stakeholders and partners. We still anticipate challenges, but this decision gives pharmacy a path forward for changes in states other than Arkansas.

We will continue fighting for independent pharmacies to preserve the valuable services, patient care, and economic support they provide their communities.

We look forward to updating you in the future.

Jay Romero
President
EPIC Pharmacy Network

State and National COVID-19 Distribution Plans

In the U.S. government’s efforts to develop, distribute, and administer COVID-19 vaccines, the Centers for Disease Control and Prevention (CDC) has released executive summaries from COVID-19 vaccine playbooks.

The executive summaries provide an overview of how each jurisdiction is thinking about and planning for the different phases of COVID-19 vaccine distribution and administration – from limited to abundant supplies – all while also dealing with the pandemic’s effects. 

Many, but not all, of the COVID-19 Vaccination Program activities described may overlap with routine activities; routine immunization and pandemic influenza program activities can serve as a foundation for COVID-19 planning. 

Strengths from the playbooks include: 

  • Organization around the phased allocation assumptions and determining populations likely to be selected for initial vaccine administration.
  • Detailing systems to train and equip providers around adverse event reporting, and 
  • Focusing on second dose reminder systems and providing in-depth operational detail for reminders via text, email, and automated calls – a critical step to ensure people who are vaccinated get the full protection a vaccine provides.

The next update to the states’ interim COVID-19 vaccination plan will include changes informed by the CDC’s new playbook and other sources of feedback. The DOH will post the revised version of the plan on their COVID-19 Vaccine page once complete.

Medicare Part D Savings Model Caps Insulin Copays

The Centers for Medicare and Medicaid Services (CMS) has created the Part D Senior Savings Model for the 2021 plan year.

Under this model, participating enhanced Part D prescription drug plans, as well as Medicare Advantage plans, with prescription coverage will provide Medicare beneficiaries access to a broad set of insulins at a maximum copay of $35 for a month’s supply from the beginning of the year straight through the Part D coverage gap.

Additional Resources: