Back to the Future of Pharmacy
Posted by: Gerald “Pharmacist Jerry” Finken, RPh, MS Contributor: Meghan Robbins
Change can mean starting from scratch, but it can also mean looking to the past for lessons learned. As big corporations push for new disruption, North Dakota is the only state in the union looking to the past for inspiration by example.
According to an article written by the Institute for Local Self-Reliance, North Dakota was doing something right in 1963 when they enacted the Pharmacy Ownership Law. This law mandated that pharmacies could only be owned by pharmacists. Over time, their order of operations was repeatedly threatened. Then finally, push came to shove, and on November 4, 2014, North Dakota was forced to vote on whether or not to overturn the law. You see, Walmart had obtained enough signatures to challenge the law at the polls. To their credit, the good people of North Dakota were not swayed and chose not to overturn the law. In fact, they didn’t fold any of three times this same movie was replayed. Clearly, the people of North Dakota are for the independent pharmacies. What is concerning is that this law continues to be repeatedly challenged.
As of 2014, North Dakota had 171 independently owned pharmacies with no Walmart or Walgreens to compete with. They have made a commitment to having their pharmacies run by people who will put their patients’ healthcare needs above everything else, including the big bucks. Companies like Walmart are fighting against North Dakota’s unique pharmacy law because they want to get their foot in the door. They are completely absent from the state and are losing money because of it.
Here’s the thing. North Dakota is excelling because of their disruptive approach to pharmacy. Compared to South Dakota, which has similar demographics to North Dakota, not only are their prescription prices lower, but they climbed slower year-over year (see ilsr.org report here). In addition, the pharmacy ownership law has allowed North Dakota to have 51% more pharmacies in rural areas than South Dakota. If the law was overturned, about 70 of North Dakota’s pharmacies would have to close, with 25 of them serving sparsely populated areas. The state of North Dakota would be at a disadvantage as well. Direct economic losses would fall on the state totaling as much as $29 million. More importantly, patients would lose access to their medication expert.
The pharmacy ownership law is paving the way for better healthcare. The patients are North Dakota’s testimony that this model is working. Not only are they obtaining better care, but their prescription drugs are cheaper. This begs the question: can you go backwards in order to move forward? Many think that North Dakota is stuck in the past when in reality they may be paving the way for a new kind of disruption. This type of disruption sticks with what works and is successful because of it.
What do you think?