Ron’s Apothecary in Juneau, Alaska will close their doors next week after nearly 50 years of caring for patients spanning multiple generations. This is the 3rd Independent Pharmacy in Alaska to close in past year with several others closing in recent years due to the abusive and unfair business practices of Pharmacy Benefits Managers (PBMs). PBMs are wreaking havoc on our public health and healthcare access infrastructure in Alaska and we are sounding the alarm on their egregious practices that are harming patients and pharmacies. PBMs are a little-known middle man that decide which drugs are covered on your health plan, how much you pay at the pharmacy counter, and which pharmacies you can use.
PBMs employ opaque reimbursement methodologies that result in frequent and drastic underwater payment to local pharmacies, while often times charging plan sponsors much higher rates. This practice is called spread pricing- ultimately driving up the cost that consumers pay in the form of premiums and copays. PBMs also charge pharmacies a dizzying array of nonsensical fees and corporate-sponsored theft in the form of clawbacks, credentialing fees, claim submission fees and direct and indirect remuneration fees amongst many others. Clawbacks are one of the most egregious. These happen long after the patient has left the pharmacy with the medication and the pharmacy has paid their staff and other expenses and have no specific reasoning tied to them, other than the fact that the PBMs are only looking out to line their own pockets. Additionally, PBMs have used vertical integration to monopolize the healthcare and pharmacy landscape – 3 PBMs own approximately 80% of the entire pharmacy benefit business and have used their monopoly power to drive their own profits. All three of these companies rank towards in the top 15 of the fortune 500 – they are some of the richest and most profitable companies in the world.
One way they drive their own profits and harm our communities is by steering patients to their own mail order pharmacies. This steering robs patients of their right to choose where they access their medications and result in local pharmacy closures and pharmacy deserts that threaten the health of our communities. Having access to a pharmacy in your local community is critical – especially when you need an urgent or acute medication. Where will you turn if we let PBMs continue to run our local pharmacies out of business? Mail order prescriptions often take up for 7 to 10 days to arrive in Alaska (if they are not completely lost in transit) and are often frozen, inappropriately thawed or otherwise unsafe for use.
There are many, many other egregious business practices that PBMs engage in that are driving up the cost of drugs and harm patients. The Alaska Pharmacy Association along with the Alaska Native Health Board are working to fix this broken system, but we need our community members and policy makers to be willing to help us with this complex issue. SB 121 is bill that we strongly believe will help curb these practices and give patients their right to choose where they get their medications as well as drive down the cost of drugs for Alaskan patients and employers. The Alaska Board of Pharmacy, The Alaska Primary Care Association and many other healthcare organizations and providers are in support of this legislation.
Please reach out to Brandy Seignemartin at email@example.com to learn more.