By C. Julia Nelson

Independent pharmacies are not in business for the money.

In fact, it’s a feat for such an establishment to stay afloat as pending federal regulations on fixed prescription costs may jeopardize the stability of independent, or community, pharmacies by undercutting the costs they pay for medications under Medicare Part D and welfare services.

It’s a situation that has Howell Mill Pharmacy owners John T. Sherrer and his wife Sharon Sherrer, R.Ph. encouraging legislators to reconsider.

“You can’t increase (fixed) prices if rent goes up because of insurance companies and federal government (regulations),” Dr. Sherrer said. “(The) supply and demand (theory) doesn’t work any more.”

As stated in a report entitled “Deficit Reducation Act of 2005: Impact on the Medicaid Federal Upper Limit Program” released by the Office of the Inspector General of the US Department of Health and Human Services, community pharmacies may be forced to accept underpayment from the states on generic medications provided to Medicaid Part D patients. It’s a problem that persists based on a lack of regulated acquisition costs for medications that community pharmacies carry to serve mostly underserved populations.

In response to the pending regulations, the National Community Pharmacists Association (NCPA) is raising awareness about the issue. A press release issued by NCPA in June, suggested a new reimbursement formula be put into effect to soften the blow to community pharmacies by providing an accurate reflection of community pharmacies’ acquisition costs.

“Medicaid cuts are threatening consumer access to medications and pharmacy services as a result of the Medicaid pharmacy reimbursement formula,” Bruce Roberts, R.Ph., NCPA Executive Vice President and CEO, said. “By underpaying community pharmacies for dispensing Medicaid prescription drugs, initial saving will lead to enormous expenses later on when patients are unable to go to community pharmacies for their medications.”

“Pharmacists are really worried,” Dr. Sherrer said. “We’re trying to get reasonable pay plans for Medicaid.”

It goes to show that in today’s big box economy, community pharmacies are a rare breed facing possible extinction.

“When you see an independent pharmacy, you see people who are willing to go out on a limb and who love what they do,” Dr. Sherrer said.

In effect, it’s an understatement for the Sherrer’s who are partners in nine independent pharmacies throughout the Atlanta area. Their love of fair pharmaceutical practices has spawned into a vested interest in keeping these independent pharmacies thriving.

“We are surviving on doing things the chain stores don’t want to address,” Dr. Sherrer said. “Because we’re not a big corporation, we decide what we want to do.”

One of the Sherrer’s main interests is located at 1970 Howell Mill Road in Buckhead. Howell Mill Pharmacy offers a vast array of unique services not likely found at big box pharmacies. These range from supplying emergency responders with medical emergency boxes or unit doses to psychiatric adolescent hospitals to medical therapy management, externships, internships, delivery, flu shots and above all, friendly professional service.

“We go the extra mile. Our people are not a number like they are in some of the other stores that are close by,” Sherrer said. “We know our patients; we know their families. It’s like being part of the family. Everybody knows everybody and everybody looks after everybody.”

The pharmacy began in 1952 as a partnership between two men, Dr. Hopper, R.Ph. and Mr. Lindsey Neely. Over the years, ownership changed hands three times and at one time it housed a soda fountain. It now features an extensive gift shop. Although ownership has changed, Tommy Bryson, R.Ph., has been the common thread at the Howell Mill Pharmacy since its inception.

“We’re now seeing fourth generation clients,” Dr. Bryson said.

According to Sherrer, customers return because of a deep appreciation for the consistent, professional and neighborly service they receive. As an independent pharmacy, Howell Mill strives to maintain strong relationships with its clientele to keep them coming back. Sue Pate, a resident of Buckhead, has been loyal to Howell Mill since 1968. “They’re very good; they know their customers,” Pate said. “They go out of their way to handle any problem a customer has.”

When Pate’s 94-year-old mother-in-law needed a medication consultation to keep her multiple prescriptions in order, Pate looked to Howell Mill Pharmacy to provide medication therapy management, a service Howell Mill offers to ensure patients are not over-medicating.

“It’s creating a profile (of a customer based on current medications),” Sherrer said, “and seeing how we can make their life better.”

Pate said the consultation her mother-in-law received is an example of the exceptional level of customer service she expects from Howell Mill Pharmacy.

“They took the list of her medication needs and she got the best plan,” Pate said. “You just don’t get that from a big pharmacy like you do from a neighborhood pharmacy.”

As an added bonus, Howell Mill Pharmacy offers a delivery service for everything from medications and support hosiery from the pharmacy to birthday cards and baby booties from the gift shop.

“You can’t put a price on (delivery services),” Sherrer said. “Anything that we have, you can get it. If you call by 3 O’clock, you’ll get it that day.”

While delivery makes getting medications extremely convenient for individuals, Howell Mill also extends services to area ambulance services, emergency rooms and fire departments. Medical emergency boxes, or 911 boxes, consist of the pharmaceutical medications these emergency responders must have on hand at all times. For the last 15 years, Howell Mill has kept these important assets filled with the necessary supplies.

“There are certain medications that have to be on an ambulance when they answer a call,” Sherrer said. “Once they use those medications, they bring (the boxes) back here to be replenished.”

While customers are the top priority for Howell Mill, it is also deemed important to provide life experiences for pharmacists in training. Every five weeks, Howell Mill Pharmacy welcomes a new pharmaceutical student from either Mercer University or the University of Georgia to sample the community pharmacy environment.

Alexander Garrard, a fourth year pharmacy student at Mercer University recently completed his externship at Howell Mill.

“I’ve learned a lot about the logistics of a pharmacy,” Garrard said. “It’s good to see behind the scenes, how a community pharmacy actually works.”

Dr. Sherrer views the experience their students have as an opportunity for an information exchange. As the pharmaceutical business evolves and new problems arise, interns and externs, while gaining life experience, offer solutions they learn in the classroom that may or may not have been considered by the pharmacy previously.

“It’s a good way to keep up,” she said. “We teach them but they teach us too. Pharmacies are changing so quickly now, the schools are trying to keep up with what they perceive as the changes.”

Every fall, flu shots are accessible at Howell Mill Pharmacy for about $25 depending on supply and demand. Appointments are not necessary and businesses can arrange to have shots brought in-house for employees simply by calling (404) 355-5650.

The pharmacy is open Monday through Friday 9:00 a.m. to 6:00 p.m. and on Saturdays from 9:00 a.m. to noon. It is closed on Sundays.

Howell Mill Pharmacy is an accredited member of several professional institutions including the NCPA, Georgia Pharmacy Association, the American Pharmacy Association and the Georgia Society of Health Systems Pharmacists.

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