(The Center Square) – Legislation restricting the actions of unscrupulous pharmacy benefit managers, or PBM’s, heads to the governor’s desk this week.
The issue has seen bipartisan support in both chambers. Sponsored by Jessica Benham, D-Carrick, the efforts to promote the bill received testimony from independent pharmacists across the commonwealth.
“After visiting pharmacies in rural areas, small towns, suburbs and cities across the commonwealth, it’s clear the way pharmacy benefit managers are currently operating is contributing to community pharmacy closures and rising drug costs,” said Benham.
The bill grants oversight into the PBM process, requiring them to report the rebates and payments they receive from drug manufacturers and how they are disbursed. It will ban PBM practices like patient steering, spread pricing and retroactively recouping money paid to pharmacies.
The “big three” PBM’s – 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.
These practices have resulted in the closure of independent pharmacies in droves, leaving the state with wide “pharmacy deserts” where the most vulnerable patients can’t easily access medication. In the first six months of 2024 alone, the commonwealth lost over 140 pharmacies.
Critics of the legislation argue that it expanded the scope of practice too broadly by allowing “inexperienced” pharmacy technicians to immunize patients as young as eight.
Rep. Seth Grove, R-York, said nursing aids and medical assistants – who have far fewer training requirements – can already administer vaccinations.
“If this stops, rural Pennsylvania will be without access,” he said.
