Deborah Keaveny took the road less traveled not only to independent pharmacy ownership but also independent pharmacy grassroots advocacy. We recently spoke to Keaveny about her unlikely journey from working for a big box pharmacy and pharmacy benefit management company, to owning an independent pharmacy and leading the charge in important industry matters, including fighting against PBMs.
Keaveny doesn’t take ‘no’ for an answer, which is good news for her fellow independents in the Gopher State. But early in her career, she said ‘yes’ to working for a chain pharmacy a few years after graduating from pharmacy school at South Dakota State. This was a good fit for Keaveny for several years and she was promoted a couple of times to higher management positions.
Eventually, she noticed a culture shift, one which wasn’t favorable to how the company had traditionally treated employees and customers. Feeling it was time for a change, Keaveny accepted a job with a pharmacy benefit management company. She admits not truly knowing what a PBM was at the time.
“Boy did I get woken up,” Keaveny said.
Keaveny experienced many different areas within the company, including assembling pharmacy networks, contacting pharmacies, auditing, and working with the call center. During this time she married an independent pharmacist, Kelly, whom she had known from her time with the chain pharmacy group. He relocated to Minnesota in 1996 to buy his father’s store in nearby Cokato.
Eventually, her employer started getting more aggressive with forcing low reimbursement rates.
“That was the start of me realizing this was something I didn’t want to be a part of,” Keaveny said.
Her company’s increasingly cut
-throat polices were also starting to have an impact on her husband’s business.
It wasn’t long before Keaveny made the decision to leave the PBM and join the ranks of independent pharmacy. Keaveny and her husband have owned as many as 11 pharmacies at one time but have pared down to the two locations in Cokato and Winsted, both small towns about an hour west of the Twin Cities. Keaveny runs the Winsted location while her husband operates the store in Cokato.
“I absolutely love the small town. All you have to do is take care of people and be good to them and they’ll go to the ends of the earth to help you,” Keaveny said. “You actually feel like you are doing something that is good, something that makes a difference.”
Keaveny adds that it is becoming increasingly more difficult for independent pharmacies to thrive and make a difference for their communities. During the height of the pandemic, the federal government elected to partner with big box pharmacies for the vaccine rollout. Minnesota’s state government followed suit.
Keaveny felt she had to do something to bring the vaccine to small towns like hers. She started by reaching out to her local state senator and representative but quickly realized one or two voices wouldn’t make a difference.
“I made my way to St. Paul (state capital) and made a whole bunch of noise because people in my little town don’t have access to a CVS or a Walgreens,” Keaveny said.
“I let them know we already give vaccines every day. This is part of what we do."
She spoke to other state senators and representatives, some of whom were on the HHS Finance Committee, who were sympathetic to seniors and healthcare matters. One legislator even walked her over to the Minnesota Department of Health to state her case.
“I let them know we already give vaccines every day. This is part of what we do,” Keaveny said. “Independent pharmacies can reach many more people than keeping the vaccine limited to the big boxes and making people drive long distances.”
Once Keaveny got her foot in the door at the Minnesota Department of Health, she stayed persistent and kept the dialogue alive, which made the department more receptive. The Community Pharmacy Enhanced Services Network (CPESN) was also in the background working with states to get independent pharmacies access to the vaccine as well.
“It was a perfect storm where a lot of people were talking to a lot of different decision-makers and finally everything came together and smaller pharmacies were able to get the vaccine,” Keaveny said.
Her advocacy efforts don’t stop there. Keaveny started a Google Group of 100 fellow independent pharmacists in Minnesota where they can work through issues and build strength in numbers. In addition to sharing business ideas, group members have joined forces on legislative matters.
Most recently, Keaveny’s group raised its voice on a 2019 state law that is supposed to regulate the unfair practices of PBMs. Feeling the law was not being enforced, Keaveny successfully recruited fellow pharmacists to testify at committee hearings. For many, this was the first time they participated in a grassroots effort to protect community pharmacy. For the state commerce department, Keaveny’s coordinated awareness effort marked the first time the department realized there was a problem.
Her group also tried to get some new legislation passed this year but came up short.
“I’m looking forward to 2022, this past year served as a proving ground,” Keaveny said. “Now that we understand how the sausage is made with how bills are passed, I think we have more confidence that we’ll be able to push what we want to push through.”
With regard to organizations like NCPA and the Minnesota Pharmacy Association, Keaveny says her group will stand alongside them when goals are aligned. When goals are not aligned, the grassroots group is prepared to pursue change independently.
Two issues Keaveny and her group plan to tackle in 2022 are patient steering and PBMs forcing independents to sell drugs below acquisition cost.
“What we need is more independents who are pushing state organizations in the right direction so they’re doing the job for us,” Keaveny said.
Independent pharmacists in Minnesota are lucky to have someone like Keaveny, who once wore the other jersey, well-positioned to fight for them.
Learn more about Keaveny Drug by visiting their website.