Your small town community pharmacists say they’re under threat from an unregulated industry which they believe limits the choices consumers have to buy their medicine. They the blame the problem on “middlemen” drug suppliers called pharmacy benefit managers (PBMs).
This year, Republican lawmakers in Georgia and Washington, D.C. are doing something unusual about it – asking for more regulation of the industry.
Mark Parris operated two pharmacies in Blue Ridge, Georgia for 19 years. He sold both in 2014 after he says about 30 percent of his patients were forced to get their medicine elsewhere.
Hinky Wilcher is one of those patients.
“[I] always took everything to him because he was the town pharmacist,” said Wilcher. “And, one day I got in the mail that I wasn’t to go to him for my long-term prescriptions.”
Wilcher says the letter came from a company called Caremark, a pharmacy benefit manger, which often sets the price you pay at the pharmacy.
Wilcher says Caremark said she could only buy her drugs at CVS.
“I didn’t like it at all,” said Wicher. “I felt like I was betraying my pharmacist.”
Parris was furious when he found out.
“I was livid as a pharmacist that I can’t take care of this patient. It’s not her choice she has to leave, but she is forced to go somewhere against her will using someone she may not trust and most of the time forced to use a mail order,” said Parris.
CVS owns Caremark. So, there’s an incentive for the PBM to set lower prices at pharmacies it owns to push customers away from other pharmacies.
Parris says that business model makes it difficult for small-town pharmacies to survive.
Eddie Madden owned a pharmacy in Elberton for 42 years. He sold it in 2013 because he claims PBMs were slowly eating away at his business. Madden had planned to work behind the counter for another five to ten years, but retired early.
“I could see the future and the future was going to be even more dismal and that’s why I elected to retire as soon as I did,” said Madden.
Lawmakers in Georgia and Washington, D.C. are taking notice to community pharmacists’ complaints.
Georgia Congressman Doug Collins (R-9th District, Gainesville) planned to re-file legislation on March 2 that would prohibit a PBM from forcing consumers to use a pharmacy it owns.
“That just sounds logical to most people, but for the pharmacy benefit manager people, [it’s] a controlling of the market,” said Collins in an interview with 11Alive News last year. “That’s nothing but corrosion, bottom-line.”
Congressman Collins’ bill would also limit sharing personal health information with pharmacies own by PMS.
CVS Caremark declined interview requests for this story. Instead, its spokesperson sent an email, stating “The CVS Caremark network of retail pharmacies includes the majority of independently owned community-based pharmacies, as well as national and regional retail pharmacy chains. Ultimately, it is the client, not the PBM, that makes the final decision about which pharmacy network their members use.”
Parris hasn’t left the pharmacy profession yet. He got another job at one of the same companies be believes forced him to sell his business -- CVS.
He supports Collins’ legislation and knows losing his job is a potential consequence of supporting it. “It’s true…and I stand by it,” said Parris.
The Georgia legislature is also considering legislation to regulate PBMs. State Sen. Jeff Mullis (R-53rd, Chickamauga) and State Rep. David Knight (R-130th, Griffin) filed identical bills this session called The Pharmacy Patient Fair Practices Act.
Senate Bill 103 and House Bill 276 would ensure pharmacists are able to communicate openly with patients about prescription pricing and drug alternatives. It would also close a loophole in current Georgia law which would then prohibit PBMs from requiring patients to use mail-order pharmacies.
Both bills passed unanimously in both chambers of the state legislature on Wednesday.