ZERO-ing in on Protecting Pharmacy Access

Jason Dykstra is a pharmacy advocate’s dream. Bright, fearless, articulate — the central Arizona-based pharmacy owner is doing everything he possibly can to keep his rural community pharmacies open in the face of unmitigated PBM greed.

His pharmacies are busier than ever, but reimbursements have never been worse. He’s concerned. If he’s forced to close his pharmacies his patients will be left with few options. For some of his patients, mail order simply won’t be an option.

At the same time, there’s so much attention on PBM reform that the country’s largest pharmacy organizations are urging members to tell Congress to “finish the job!”

That’s great, but what job are we asking them to finish? Which of the 50+ PBM bills introduced in Congress will stop PBMs from reimbursing pharmacies below drug acquisition cost all together; will require pharmacies be paid a professional dispensing fee to cover costs; will ensure pharmacies patients aren’t steered away from them; will ensure pharmacies are given a fair opportunity to be classified as “preferred” instead of discriminated against because they are a small business and not a national chain?

A few bills touch on these issues, but the overwhelming majority don’t… and none go far enough. Essentially the answer is Zero.

Most of the PBM reform bills do not do anything to meaningfully protect the business of pharmacy. So when PBMs are required to turn 100% of their ill-gotten gains from revenue generation schemes including (but not limited to) rebate aggregators, discount card games and copay accumulators/maximizers, pharmacies will not be protected from having to make up the difference out of their own pockets. We know that to be true. We’ve been living it for years.

So if so much attention is on PBM reform, why aren’t there more bills helping pharmacies (even the large ones) level the playing field?

Because pharmacists are nice people, and so are the organizations that represent them. Because nobody wants to tell the truth. Because telling the unvarnished truth might sound like pharmacies are all about the money when the truth is patient access begins with an open pharmacy. No business and certainly no pharmacy — not an independent, not a Walgreens, not a Walmart — can remain open if paid below cost of goods sold and not paid at all for services rendered. Just ask your local Congressman — some are business owners and most come from a business background. Do we really think they couldn’t handle the truth?

Don’t get us wrong. We celebrate this moment in time when states and the federal government are working to fix the PBM problem. These efforts aren’t wasted and they will go a long way toward protecting patients, employers and taxpayers.

But if we’re going to “finish the job” let’s finish the right job, the one that includes the patient’s access point. Let’s include the pharmacies, because they’ve been the ones paying the price for PBM greed all along.

In advocacy,

Deborah Keaveny, President

Lauren Young, Vice President

Monique Whitney, Executive Director

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