March 28th 2024
Health Provider Services Committee
Testimony to be delivered April 2, 2024
Rep. Al Cutrona, Chairman
Mr. Chairman and members, on behalf of Heartland Impact, I am here today to thank you for your work to improve patient’s access to care and share our support for HB136.
Heartland Impact is the advocacy and outreach affiliate of The Heartland Institute, a nearly 40-year-old public policy research organization based in Arlington Heights, Illinois. Both are independent, national, nonprofit organizations working to discover, develop, and promote free-market solutions to social and economic problems. Heartland Impact specializes in providing state lawmakers with the policy and advocacy resources to advance free-market policies towards broad-based economic prosperity.
Heartland has long supported telemedicine policy reforms that improve access and convenience for patients, while implementing safeguards to maintain safety. Remote dispensing pharmacies are one more vital way to address the growing access to care crisis in Ohio.
During the pandemic, telemedicine was given a trial by fire as states were forced to immediately replace face-to-face office visits with virtual ones as clinics and hospitals shut down all nonemergency care in the spring of 2020. In 2022, there were 38 times more telemedicine visits than 2019.
Ohio is one of 22 states that have yet to implement tele-pharmacies. Indiana and Michigan have already taken this step. When the pharmacy closures began to accelerate about a decade ago, the term “pharmacy desert” began to be used in committee rooms like this.
A widow named Rose moved to a town of 900 from the farmhouse she was born in 84 years ago. When the family can drive her, Rose now travels forty miles away to the doctor. Until it closed, her medical clinic was within walking distance from her small house. For Rose, the Mainstreet pharmacy has become her de facto primary care provider.
In deep rural America, the pharmacy can be seen as one of several vital organs keeping the town alive. The loss of a school, nursing home, or rail connection can start a deathspiral of a small community, but the loss of the town pharmacy is often the nail in the coffin.
The United States has lost ten percent of its rural pharmacies in the last 20 years. One in three Americans now live in an area with less than one pharmacy per 10,000 people.
Until the pandemic, Rose’s story was the story of the pharmacy desert in America. Now, the desert has moved to the cities and suburbs as well. Five percent of the total number of urban pharmacies have closed since 2016. Wallgreens, Rite Aid, and CVS have all closed stores in the Dayton area, and in recent years, together have signaled plans to close more than 1,500 stores nationwide.
Gary lives in an area much like West Dayton. Gary relies on public transportation and walking to get his prescriptions and much of his food from a local pharmacy.
Neither Gary nor Rose has a computer. They don’t drive. Both manage high blood pressure with medication. Their local pharmacy means more than convenience. For them, access to a pharmacy is key to maintaining independence and health.
A 2019 study by the Journal of the American Medical Association (JAMA) found that “pharmacy closures are associated with persistent and clinically significant declines in adherence to cardiovascular medications among older adults in the United States.” And “Efforts aimed at reducing barriers to prescription medication adherence should consider the role of pharmacy closures, especially in patients at highest risk.”
Changing business models, consumer behavior, declining populations, drug purchasing mechanisms, crime and other factors combine to create a growing crisis in access to pharmacy goods and services. This committee is tacking this challenge head on in many ways.
Remote dispensing pharmacies are one way to keep more Ohio pharmacies from closing. HB136 balances access to care with important patient safety measures to put the best interests of the patient as the primary consideration.
Thank you, Mr. Chairman and members.
Heartland Impact is here to provide you and your constituents with the best policy analysis. Please don’t hesitate to contact us if we can be of assistance! If you have any questions or comments, contact Heartland’s government relations team at 312-377-4000 or www.heartlandimpact.org
