Independent pharmacies rally for help against ‘the big three’



(The Center Square) – Independent pharmacies took center stage earlier this month in support of a bipartisan bill that would rein in the “shadowy middlemen” who control contracts between their businesses and drug companies.

State Reps. Jessica Benham, D-Carrick, and Abby Major, R-Ford City, held a press conference with Dave Cippel, president and head pharmacist of Klingensmith Drugstores, at their Ford City location on May 10 to promote the legislation.

Klingensmith employs 98 people and makes deliveries to about 100 homes per day, creating ties to the community that Cippel says cannot be replaced when independent pharmacies close their doors.

“Nothing good happens in a small community when their local independent pharmacy closes,” he said.

Among Klingensmith’s seven locations are stores that offer the only service for miles, making them a vital lifeline to rural communities already hit hard by health care office closures and staffing shortages.

Cippel noted that in the past month, twelve community pharmacies have closed in western Pennsylvania alone. He and other independent pharmacists contend that unfair reimbursement contracts offered them by pharmacy benefit managers, or PBMs, make business untenable.

“Every year we say it can’t get any worse,” he said.

Benham’s plan, House Bill 1993, creates a path for pharmacists to register complaints against PBMs and requires more transparency about rebates and payments made by the PBMs and how they distribute them.

Benham emphasized that people who like to get their prescriptions filled at major chains should still have that opportunity, but they shouldn’t be the only option.

“No matter where you fill your prescription, your pharmacy can continue operating,” she said.

According to Benham and Rep. Valerie Gaydos, R-Moon Township, the bill would regulate several PBM practices that unfairly skew the market, such as patient steering, spread pricing and retroactive recoupment of money.

As it stands, “the big three” – Caremark, Express Scripts and Optum – control over 90% of the prescriptions filled in the nation. They use vertical integration structures to profit from every level of the patient process, from clinic to prescription.

The issue spans the state, impacting both rural and urban communities. The pharmacy deserts created when independent owners shutter their doors create major obstacles for those without reliable means of transportation and those suffering from chronic illness.

Broad support for the bill and another put forth in the Senate leaves supporters optimistic that it could pass in June.

“There is absolutely no reason we cannot have this done by the end of June. Our communities’ health and lives depend on it,” said Major.

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