Pharmacy reform passes state House

(The Center Square) – The state House OK’d a bill Friday that, if passed, will reign in pharmacy benefit managers, which impact prescription pricing and put pressure on independent drug stores across Pennsylvania.

“We need to create a level playing field for our community pharmacies so that they can compete fairly with the big guys. We’re taking on corporate greed, and I believe we will win,” said the bill’s sponsor, Rep. Jessica Benham, D-Carrick.

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 bill grants oversight into the pharmacy benefit manager, or PBM, process, requiring them to report the rebates and payments they receive from drug manufacturers and how they were disbursed. It will ban PBM practices like patient steering, spread pricing and retroactively recouping money paid to pharmacies.

The practices have shuttered 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.

“I’m standing here to say, ‘no more.’ In this House, we stick up for the little guy. We fight for our small business and that absolutely includes our main street pharmacies,” said Benham.

Those main street pharmacies are essential in both rural and urban areas of the state. Closures in rural areas can create gaps of several miles between providers. Large chains like those connected to the big three tend to avoid opening stores in areas with higher crime rates, exacerbating the negative health impacts of poverty.

The bill will now move to the Senate, which has seen similar legislation. In both chambers, PBM regulation enjoys bipartisan support.