How PBMs Impact Independent Pharmacies

Within the pharmaceutical supply chain, pharmacy benefit managers (PBMs) were once little-known entities in the eyes of Americans, serving just one small part of a long process. However, as more and more of their questionable and opaque business dealings have come to light, PBMs have become the single most scrutinized group within the drug supply chain.

As more of their opaque business dealings come to light, PBMs have become the single most scrutinized group within the drug supply chain. | image credit: Alon / stock.adobe.com

While PBMs were originally designed to save patients money, they have since pivoted to controlling a majority of the market and driving more revenue toward major corporations, especially the “Big 3” PBMs: CVS Caremark, Express Scripts, and OptumRx. Amidst lowering reimbursements and various contracts and fees that PBMs force to be accepted and paid, independent pharmacists have been hit the hardest by PBM practices.

Tom DePietro, PharmD, owner of DePietro’s Pharmacy in Dunmore, Pennsylvania

“In essence, they control the transaction from A to Z. If your drug’s not covered, if your copay is expensive, if you're forced to use the mail order; that's all the pharmacy benefit manager. Often, I will say, our patients choose us. Our patients choose their doctors. They often will choose their health insurance company but what they don't get a chance to choose is their pharmacy benefit manager because it's always just wrapped into the plan,” said Tom DePietro, PharmD, owner of DePietro’s Pharmacy in Dunmore, Pennsylvania.

DePietro has been vocal about advocating for PBM reform and putting money back into the pockets of independent pharmacy owners. While he may not have every answer as to how to fix the power imbalance between PBM corporations and independent pharmacies, he knows that the issue must be fixed or the future of pharmacy is in for a dangerous road ahead.

READ MORE: NCPA Representative Discusses Role in Influencing PBM Reform

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