Once again, big retail stores who also run pharmacies are trying to overturn North Dakota's pharmacy requirements. Right now, a pharmacy in North Dakota must be at least 51% owned by a licensed pharmacist. Because Walmart, Walgreens, or other supermarkets are not owned by actual pharmacists, they cannot open in the state.
The big stores argue that they would provide cheaper drugs to North Dakotans than local pharmacists can if they were allowed to operate here. Many of them now publish lists of prescriptions they offer for $4. "Hundreds of Prescriptions" are claimed. However, out of the 310 drugs which Walmart lists, only about 135 are unique drugs; most of them are repeated as different dosages once or twice, Amoxicillin is listed 16 times. And among the drugs on the list is Ibuprofen.
The list, of course, does not apply to high cost drugs. It also does not work in conjuction with any other financial aid including insurance, which covers 93% of North Dakotas seeking a prescription.
Everyone is hoping to find things for less. But the fact is that North Dakota already has a cheaper average prescription cost than the national or regional average. We also have more pharmacies per person which would suggest greater competition between businesses. For contrast, over 50% of the pharmacies in Sioux Falls, Billings, and Cheyenne, outside of North Dakota, are shared between only 3 businesses.
However, as Kevin Oberlander, a local pharmacist explains, costs are not in a competition system, "it is a managed system" of "take it or leave it contracts" and the $4 prescription promise is a marketing ploy. "These are high profit companies, They know how to make money." If they are offering $4 prescriptions, they are making that cost up somewhere else.
The real issue to Kevin is access to care. "The law is good for the patient. I will argue that to the bitter end." Kevin has colleagues in other states jealous of our requirement. One of his friends, who has worked in a big-box store pharmacy and has some ability to fight for his patients still has decisions made for him by non-medical people. "It is not about the patient. Sometimes decisions are made for us and we have no say in that."
"We are not guaranteed low prices, especially when competition goes away." says Mike Schwab Executive Director of the North Dakota Pharmacists Association. Along with Oberlander, he fears that if the law passes, we will lose many of our pharmacies and that once we lose them, we cannot get them back. "People will lose access to care." says Oberlander. Compared to South Dakota and other similar states, we have fewer counties without a pharmacy and these big box pharmacies have been involved in many court cases for unethical conduct in the last few years. Which North Dakota has not had to suffer.
North Dakota is the only state in the Union which still has a pharmacy ownership law, which Mike believes is good for health and safety; the supreme court agrees as this issue has made it to that level in the past. We should "value being the only state with this law." says Mike, "sometimes being different is a good thing and I like to think that there was some foresight here".
