Governor Bill Lee has signed into law legislation aimed at protecting independent pharmacies from rising fees and patient-steering associated with the companies that manage prescription benefits on behalf of health insurers. Greg Bohannon, co-owner of Thrifty MedPlus Pharmacy in Ooltewah, says pharmacy-benefit managers, which have ballooned into monopolies in recent decades, are unfairly targeting small pharmacies.
The bill prevents PBMs from discriminating against hospitals and clinics participating in a federal drug-pricing program which allows them to buy medications at reduced rates, allows patients to choose their own pharmacy, and creates transparency for patients and providers on drug pricing and co-pays. Pharmacy-benefit managers say their industry helps lower drug costs for patients.
Bohannon explains PBMs use a number of tactics to increase profits, which often result in patients and small pharmacies footing the bill.
“A lot of times they actually pay the pharmacies less than what the pharmacy has to pay for the medication. Or, overreaching and ever-changing audit strategies that are employed by the PBM and their auditing companies.”
He says the state’s independent pharmacies have stepped up to serve Tennessee communities during the pandemic.
“Whether it was making hand sanitizer or sourcing some of the hard-to-get products for the store and for our customers, or curbside delivery programs.”
One survey of 600 independent pharmacies nationwide by Pharmacists United for Truth and Transparency found PBMs charged community pharmacies more than two billion dollars in medicare prescription fees in 2017 and 2018.