Ron Patel, a Fort Lauderdale pharmacist, made an impassioned call to hold ‘predatory middlemen’ (PBMs) accountable for forcing independent pharmacies out of business in an op-ed published earlier this week. Arguing that PBMS no longer negotiate medication savings on the behalf of patients, Patel identifies a few key areas that are putting unsustainable pressure on smaller, independent pharmacies.
First, PBMs hold sway in determining what prescriptions insurance will cover and how much of that selected formulary they’ll pay for. Independent pharmacies do not have the access to all of the insurers that big-box chains do. This immediately limits their scope of business. To make matters worse, PBMs are hitting these smaller pharmacies with hidden fees that they’re unprepared to shoulder. Finally, PBMs are under reimbursing.
Read the original opinion piece in the Sun Sentinel.
XIL Health Insights
Ron Patel is hitting the nail on the head here and touches on an interesting, damaging dynamic at play. Most of the pharmacies that have survived to this point are those aligned with the PBMs. PBMs are being used to literally reroute business to the pharmacies they’ve merged with. Then, as these independents fall to the wayside, the big-chains are there to snatch up newly available storefronts. The impact extends beyond independents; it’s a snowball effect. As independents close, gaps are created in communities with job loss and limited access to products and services.