Guttenberg Pharmacy addresses rumored concerns

By Molly Moser

A curious crowd gathered at the Guttenberg Public Library on Tuesday evening, Feb. 22, overfilling the nearly 30 seats in the meeting room. “What we can do tonight, I hope, is educate you and let you know what’s actually happening – not just in Guttenberg, but in the whole country,” said Joan Shannon of the Guttenberg Pharmacy. 

Joan and her husband Dan, the local pharmacist, have owned and operated the Guttenberg Pharmacy for 28 years. Murmurs of a sale, closure, or moving the business have circulated in the community, and the Shannons held the meeting to address those rumors. “We’re going to be as transparent as we possibly can. There are no hidden agendas,” said Joan. 

“I really, really am passionate about having health care in this community,” she told listeners. “This has been the greatest education… We’ve been given so many gifts from the opportunity to work in an independent pharmacy in a place we call home. We take each and every one of you seriously and to our hearts.”

While Dan dealt with medications, Joan worked with Medicare Part B for many years – homecare and durable medical equipment. “It was never easy. They were constantly trying to give us less and less money for more and more cost.”

With her background in Part B, Joan knew how challenging dealing with Medicare could be. “In 2006, there was rumbling about Medicare Part D. That’s when it started,” she said. 

When Medicare Part D came into effect, the Shannons were faced with a new reality: Owning their family business now meant being told when they’d get paid by pharmacy benefit managers. Although Medicare claims are paid to pharmacies within 15 days, private insurance payments have slowed to 30 or 45 days between prescriptions being filled and payments received by the pharmacy. During the Feb. 22 meeting, Dan said, “We just got paid for a December claim last week… At the end of the day you can have a real headache. Sometimes I have been the crabby pharmacist and I apologize from the bottom of my heart. It puts a lot on your mind, and I have a job where I have to stay focused.”

Purchasing medications to keep customers’ prescriptions filled has become a balancing act when, quite simply, money isn’t coming in for the prescriptions already filled. Joan gave an example. “Last week we threw caution to the wind because we had to have the inventory, and had to bank on the fact that some money was going to come in. I never thought red totes full of drugs would make me so happy, but for one or two days, we were going to have everything that everybody needed.” 

One week later, the pharmacy had filled $19,000 worth of prescriptions and only been paid for $4,000. “Pharmacy benefit managers have become experts at keeping that money in their pockets as long as they can. If they can wait even a couple of days before releasing payment, they have a lot of extra money on hand that they’re earning interest on,” Dan explained. “Not to mention the sweetheart deals they cut with manufacturers – that’s part of the reason why someone’s taking a medication and all of a sudden they don’t cover it, because they couldn’t cut a deal with that manufacturer.”

“In the meantime, people who live in isolated areas are digging and scratching to just stay solvent so we can keep delivering the medications that you’ve come to depend on. We don’t have the buying power of the big ones, the Walgreens and the CVSs. All I can say is it’s not going to change,” Joan said. “There is no mystery about this, this is the reality – that the independents are done.”

After months of research, Joan confirmed, “The absolute truth is that you are seeing the last of the mom and pops… As of 2013 in Iowa alone, 75 independent pharmacies have closed.”

“Partly because of the Affordable Care Act, our reimbursements have been getting smaller and smaller,” said Dan. “We made one penny on a $36 prescription last week. That doesn’t even pay for the bottle that’s going out the door. I’m not saying all are like that, but over time, what we’ve seen is a large number of prescriptions where you’re not making enough to get by.” 

The pharmacist held up a bottle of insulin with 2 teaspoons of liquid inside that costs the pharmacy $239 to have in stock. He noted popular antibiotic doxycycline changed in price overnight from $5-$6 a bottle to $600. “The cost of stuff on the shelf has escalated so much, and when these drugs have a price increase it takes pharmacy benefit managers two to three months to reload their systems so we’re often filling these things underwater,” Dan told listeners. “Every time these prices spike, we don’t benefit from that in any way. We still get paid the same from the insurance.”

John Hartmann, one of many in attendance, asked what drives drug prices so high. Joan answered frankly. “Greed. I’m sorry to say, but greed.” 

In spite of the gloomy outlook, Joan was adamant. “We will do absolutely whatever it takes for the good of this community. Just bear with us, just work with us, and we’ll get you through to whatever’s going to happen next. But over my dead body will that store not be. It may not be called the Guttenberg Pharmacy, but it will be.” 

To the applause of the audience, she went on, “My hope is, whatever does happen, we will have a pharmacist that sticks around and has a smile on his face because he’s not trying to save everything… If tomorrow we don’t have what we need and the money’s not coming in, Dan would be working nonstop to make sure you had transfers taking place wherever you needed them. We won’t just lock up. If you stick with us, that’s not going to happen.”

To keep supporting a local business and help ensure your prescriptions are available when you need them, Joan recommends calling the pharmacy one or two weeks before you’re due to run out. Though they can’t fill the prescription at that time, they can order it in advance to so that they have it on hand when you need the refill. 

“I came tonight thinking we were going to hear that you were going to close, because there’s so many rumors, so I’m very happy that you did this to tell us you’re not leaving,” said one audience member. Another chimed in, “I can get my prescription cheaper at Wal-mart, but I’d rather get it here. You guys know the people in town and what we deal with.” 

The Shannons ended their meeting on a positive note. “We’re the flesh and blood, we’re the brick and mortar, and we’ll do anything and everything until what Guttenberg needs is here, whatever that means.”