JOHNS CREEK, Ga. — Over the past year, Jennifer and Mike Shannon, owners of Lily’s Pharmacy in Johns Creek, have worked with state legislators to pass a law to prevent conflicts of interest in the pharmacy industry.
The Pharmacy Anti-Steering and Transparency Act, which will go into effect Jan. 1, 2020, prohibits insurers and benefits managers who have ownership in a pharmacy from steering patients to that business. The law endeavors to reduce conflicts of interests, increase transparency and give patients more choice.
The law was inspired in part by local pharmacist Jennifer Shannon, who saw first-hand how coercive steering practices can negatively impact patient care.
Jennifer and Mike created Lily’s Pharmacy, named after their first daughter, in 2013. While Jennifer is the head pharmacist, Mike handles business affairs, and both pride themselves on the customer service and level of care offered at the pharmacy.
“Patients should know their pharmacist,” Jennifer said. “We’re the last person that checks that their medication is safe for them. We realized there were no local pharmacies in the area – there were so many chains everywhere – so we decided to do it in Johns Creek where we live.”
Lily’s Pharmacy works closely with Emory Johns Creek Hospital and other nearby healthcare providers to ensure a quality continuum of care.
“We know them well,” Mike said. “We get a lot of referrals from the local providers because we’re out front talking with our patient and not just treating them like a prescription going across the desk.”
As with any mom-and-pop shop, competing with larger chain pharmacies can be challenging for Lily’s Pharmacy. But the biggest challenge, the Shannons said, was not attracting patients to their neighborhood pharmacy, but retaining them because of steering campaigns or restrictive insurance plans.
“A doctor can never tell you ‘Hey, you have to go to the lab, and you have to go to the one that I own,” Mike said. “That’s illegal. But in pharmacy, the [pharmacy benefit managers] are allowed to say ‘You have to go to this specialty pharmacy’ or ‘You have to use my wholly-owned, mail-order pharmacy.’”
This is not only a conflict of interest, they said, but it hurts small businesses and can be detrimental to the patients.
“You would be surprised how many people, mostly Medicare patients, are forced or coerced,” Jennifer said. “They will get letters in the mail, phone calls saying ‘You’re due for this medication. Why don’t we just send you 90 days,’ when they probably have no business getting 90 days of anything because their meds change.”
Jennifer said she has spent ours on the phone fighting with insurance companies and mail-order pharmacies to grant her clients the ability to have their medication filled at the pharmacy of their choice.
Frustrated by the system, Jennifer reached out to the lobbyist with the Georgia Pharmacy Association, and along with the Medical Association of Georgia and Georgia Society of Clinical Oncology, they developed the bill that would become the Pharmacy Anti-Steering and Transparency Act.
While mandating mail-order pharmacy was already illegal in the state of Georgia, many patients have been the target of steering campaigns that remove or complicate their ability to choose their own pharmacist.
Under the new law, the practice of steering patients, whether through insurance plans or misleading marketing materials, to a pharmacy that is owned by the insurance company or pharmacy benefit manager is now illegal and punishable by fines and possible loss of license in Georgia.
Jennifer testified before legislative committees to help ensure the bill’s passage.
With unanimous support in the Senate and one dissenting vote in the House, Georgia became a leader in ensuring patients can chose their pharmacist.
Jennifer said she is incredibly proud of the new law and hopes similar laws will be passed in other states.
“To have the choice and not be coerced will save so many patients, especially the elderly,” Jennifer said.
For more information about Lily’s Pharmacy, visit lilyspharmacy.com.