Understanding Competition in U.S. Prescription Drug Markets: Entry and Supply Chain Dynamics
I am a pharmacist/owner of a community pharmacy serving a rural community of patients of all ages. My pharmacy has been serving this community since 1968. Since patients don't need appointments to see pharmacists, I am often the first and last line of medical care in my community. Patients seek advice when something acute happens, and rely on my knowledge to ensure their safety when it comes to prescription medication. PBMs compromise that trust in multiple ways. First, I am contractually obligated not to discuss with patients that there may be cheaper alternatives in terms of medication or that paying cash would be cheaper than their copay. Second, PBMs often will pay below may actual drug cost and give a dispensing fee that doesn't cover my business costs to fill the prescription. In fact, a large portion of the dispensing fee is taken back by the PBM as a transaction fee for the pleasure electronically filing a claim. Third, PBMs strong arm patients into using their mail order or PBM-owned pharmacy. They do this by lowering co-pays or only allowing 2 or 3 weeks on prescription fills. All to often, patients come to my pharmacy to get live saving drugs when a mail order pharmacy can't deliver drugs in a timely matter. PBMs have not fulfilled the promise of saving money in the healthcare. Premiums continue to rise and PBMs make record profits. This latest bid by CVS to acquire Aetna will more than likely make the situation worse, and heralds back to the days of men like Rockefeller. I plead on the behalf of my patients that FTC fulfills its mission to protect consumers and prevent anticompetitive business practices. Please regulate PBMs and loosen the power they have over the skyrocketing price of healthcare.