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For more information about these community pharmacy/education/wellness centers, contact:

Jennifer Burch, PharmD
Sejjal Patel, PharmD
Michael Verble, PharmD
Ziyad Jabar, PharmD

Chad Clay, PharmD
Jhuvon Francis, PharmD


2609 North Duke Street, #103
Durham, NC 27704
Telephone: (919) 220-5121
Fax: (919) 220-6307


6224 Fayetteville Rd, #104
Durham, NC 27713
Telephone: (919) 484-7600

Call to schedule a consultation with our pharmacists.

Central Pharmacy:
Where a Personalized Approach Pays Off

Recent advances in pharmaceutical science, acknowledges Dr. Jennifer Burch of Central Pharmacy and Central Compounding Center, “have had an enormous and largely positive impact on our ability to treat a wide range of diseases. And one benefit shared by many of these new drugs is their ability to target diseases more narrowly and thus minimize side effects.

Dr. Burch

“But there’s one ‘side effect’ that has not been minimized,” she adds, “and that is cost. Simply put, the cost of medicine today is a serious and growing problem. It doesn’t matter if a new drug is wonderfully effective if it’s prohibitively expensive—and too many medications are.”

Drug Costs:
A Complex Issue

There are a number of factors contributing to the high costs of medicines, explains Dr. Burch. “These include the development costs of new medications, expensive oncology drugs, personalized medications, and brand name or generic medications made by only one manufacturer—which removes price competition. In addition, insurance companies—who make decisions about what drugs they will cover—add complexity and often affect cost. 

“A lot of the new medications are oncology medications,” she notes. “They usually start about $20,000 a month and go up from there. This can put those medications beyond the reach of uninsured or underinsured patients, but it also puts a strain on insurance companies. For example, I sit on a pharmacy and therapeutics committee for one of the insurance companies in the state, and they recently reviewed a drug that was an option for a drug already on the market—and which costs two and a half million dollars a dose!


“Given the complexities of the health insurance system,” says Pharmacist Jennifer Burch, “it’s not uncommon for cash prices for certain medications to be lower than insurance copays. Appre-ciating that, Central Pharmacy has identified a number of medi-cations that we can provide at a cost of $20 for a 90-day supply. These are medications commonly prescribed for gout, osteoporosis, diabetes mellitus, heartburn/ GERD, asthma, allergies, hyper-tension, hyperlipidemia, pain, and psychiatric conditions.”

For details and a complete list of included medications, go to the Pharmacy’s website: rxsavers-program/

“These new drugs are often wonderful advancements—solving major health problems with fewer side effects; but they’re also often prohibitively expensive. Another example of this are the ‘precision’ medicines. These are very specific therapies for genetic diseases based on DNA markers. But precision brings cost: since only a very small, targeted audience may benefit from a particular medication, the costs are spread across only that small group.”

Even more familiar diseases, such as rheumatoid arthritis, are now being treated with newer drugs—such as biologics—which, although they’re a major improvement over traditional medications—can cost up to several thousand dollars per month. “It often depends on the patient’s insurance company,” Dr. Burch notes, “as to whether they can afford to benefit from the new medication.”

Navigating the Challenges of Drug Costs

“Because of this increasing problem of drug costs,” says Dr. Burch, “we are finding that one of the most important services we offer our patients at Central Pharmacy is to help them navigate the complexities of health insurance and payment options.

“It begins, usually, with counseling patients so we understand the ‘big picture’ of their concerns and medications. And, from there, we will work not only with their doctors and other health care providers, but we’ll also connect with pharmacy benefit managers (PBMs). These are the mediators between each insurance company, the drug companies, and pharmacies; each insurance company’s PBM sets all the rules regarding pharmacy benefits, including copays, what tier each medication fits in, and which drugs require prior authorization—a process they manage for a fee.”

Understanding the process by which drug prices are set is important, explains Dr. Burch, “because that enables us to counsel patients on their options for paying for prescription drugs. For example, in some cases it’s better for the patient to pay cash for their prescriptions than it is to use their drug insurance because—depending on how the insurance is set up—the cash price of the drug may be less than the copay. In North Carolina, we’re allowed to tell the patient, ‘It would be cheaper if you’d just pay cash for this drug.’ And we often do.

“We’re also able to identify alternative options that may be far less expensive. And we find that most doctors will authorize a switch to a less expensive medication, particularly if it’s a cost issue for the patient. They understand if the patient isn’t going to take the medication because they can’t afford it, it doesn’t do anybody any good.”

It was the challenge of dealing with high and varied drug prices that led Central Pharmacy to create its RxSavers Program (see box), a discount program that offers fixed price discounts for 90-day supplies of certain medications. “We’re very pleased to be able to offer significant savings through this new program,” says Dr. Burch. “But there may be any number of other possible options for reducing medical costs. So we encourage our patients to talk with us about their situation so we can help them.”

Personal Approach Yields Many Benefits

Dr. Burch finds that relationship building helps her and her colleagues at Central Pharmacy to offer the best care to their patients, beyond simply the most cost-effective care.

“We talk to every patient who comes in the door—and especially want to connect with new patients who are on multiple medications or pain medications. We want the story behind the medications,” she says.

From such conversations, she says, “we often learn that patients are on multiple drugs due to side effects from other ones, or they are simply still taking medications for conditions they no longer have, or for a short-term problem that resolved. In those cases, we often work with their providers to lower the number of medications.

“These conferences also alert us to concerns about multiple drug interactions or even drug abuse. Ultimately, though, what’s most important is the relationship we build with both patients and their providers. Working together, we can help patients find the best medication regimen—one they can stay on and afford.”