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Tough dose of state cuts: pharmacies struggle to survive budget slashes

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As with many other facets of the north country’s rural health system, independent pharmacies here are struggling to survive.

Local pharmacists said the latest blow is a SilverScript plan for state retirees that does not pay pharmacies a dispensing fee, which goes as high as $5 per prescription.

“I can’t pay for people with $5,” said Patricia V. Signor, pharmacist and co-owner of Bolton’s Health Mart Pharmacy, 128 W. Main St., Watertown. “It’s a slap in the face.”

At Bolton’s, she said, at least four people handle a prescription: someone who does the intake, another who counts pills, a clerk and a pharmacist.

The retirees’ plan switch from a state-sponsored plan to Medicaid Part D SilverScript took effect Jan. 1. Kim M. and Rosemary L.Demers, owners of Kimro’s Medicine Place, 511 State St., Ogdensburg, recently reached out to their state employee customers to ask local elected officials to give pharmacies a fair reimbursement for services. They also asked state employees to ask state officials to stop mandatory mail order, which the Demerses claim is the state’s overall objective.

“They caught us by surprise,” Mr. Demers said. “With SilverScript, customers no longer pay a dispensing fee. Maintenance medicines for blood pressure, thyroid, cholesterol, et cetera, account for 80 percent of our business. Pharmacies can’t survive with the other 20 percent alone.”

He also questioned alleged cost savings to the state with mail orders, saying the last national prescription drug takeback day’s collection of more than 1 million pounds of drugs was largely through mail orders.

“Where is the savings if the drugs are being thrown away?” he said. “We could do a better job of monitoring prescriptions here so they wouldn’t have to be disposed of.”

Mr. Demers said he has the advantage of knowing who his customers are and what medicines they need.

“If we make a mistake, I can fix it right on the spot,” he said. “At best, the mail order companies can’t remedy the mistake until the next day.”

Kimro’s also has lost about 50 customers a day in the last three years, Mr. Demers said, because of overall changes in Medicare Part D.

The company, which employs eight people, has cut an insurance consultant and laid off a part-time employee as a result of losing those customers. Kimro’s also will cut back on charitable contributions and advertising.

Part-time employees recently had their hours reduced at Adirondack Pharmacy, 4057 Route 3, Star Lake, to help offset the loss the pharmacy experienced because of declining reimbursements. Matthew Scott, who co-owns the pharmacy with his wife, Diane, said reimbursements sometimes barely cover the cost of medication.

“I have a small, front-end store, and I can’t absorb losses like a big chain could,” he said.

Although he said he didn’t know the exact amount, Adirondack Pharmacy also has lost customers.

Meanwhile, Mrs. Signor said independent pharmacies will not survive with continued cutbacks. Although the Pharmacists Society of New York has lobbyists working for improvement of pharmacy-related bills, “we’re just not powerful enough.”

“You’ve got to have money to be powerful, and independent pharmacies don’t have the money,” she said.

Now, Bolton’s is looking at its bottom line. The pharmacy has been in business since 1895, and the Signors have operated it for the past 27 years. The business has grown from just two pharmacists and two pharmacy technicians in the past couple of decades to 30 employees, Mrs. Signor said.

“I don’t know how much longer I can do it,” she said. “I cut myself first; I’ve taken a couple of cuts in pay.”

Bolton’s, which has a second location within the Pediatric Associates building, 18969 Route 11, handles about 10,000 prescriptions monthly. The pharmacy had six pharmacists until one retired recently. Mrs. Signor said the company is contemplating whether another will be hired.

“It hurts,” she said.

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