In all likelihood, if you are the owner of a small independent community pharmacy, you confront direct and indirection renumeration fees and mergers among healthcare systems as chief concerns in your daily operations. Such are the findings of a survey released by the National Community Pharmacists Association.

In its recent online survey report, the NCPA revealed that direct and indirect renumeration fees, also known as DIR fees, and the consolidation of healthcare facility systems negatively impact the economic health of small independent community pharmacies, including family-owned ones. The DIR fees result from a Medicare policy in which entities who pay pharmacies take back these sums more than half a year after pharmacies fill their prescriptions. The payers state that they take back their funds based on how the pharmacies measure up on the quality of their economic and medical performance.

With respect to the mergers and acquisitions of hospitals and medical centers, community pharmacies are concerned about the effects of such consolidation on their existence and economic activity. About 97 percent of small independent pharmacies say they fear the consequences of DIR fees on their business activity and 26 percent declare that they may shut down operations if DIR fees are not corrected as a matter of public policy. The findings of the NCPA survey report are aimed at informing government and medical industry policymakers about the challenges facing small independent pharmacies and the best means of addressing them. The NCPA made the discoveries after they shared a survey with 5,000 organization-member pharmacy owners and managers in the autumn of 2021. The group received 318 replies from the member-pharmacies.

Small independent pharmacies also identify gaps in staffing, disruption in supplies, business taxes and inflation among their other problems. More specifically, a vast majority of the pharmacy respondents encounter these issues though they are not top of mind. For instance, about 41 percent of the pharmacy owners describe the economic health of their facility as “somewhat poor” or “very poor.”

Nearly 68 percent of the pharmacies have difficulty recruiting and retaining staff positions such as pharmacy technicians, front-end clerks, delivery drivers and pharmacists, all in that order. Among the four, pharmacy technicians are the hardest titles to staff. About 88 percent of small pharmacies made this claim while 62.8 percent say the same for clerks, 28.8 percent for drivers, 19.1 percent for pharmacists and 4.2 percent for other positions. Roughly 60 percent of the pharmacies state that they are plagued by supply-chain disruptions, a well-publicized, worldwide reality for a wide cross-section of industries since the onset of the coronavirus pandemic.

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