Pharmacy benefit managers make Kansans’ medications too expensive. But there’s help | Opinion

I love my pharmacy and my customers, and I believe there is nothing more rewarding than serving my community. The ability to provide lifesaving medicines and services ensures the community I love is happy and healthy.

Unfortunately, there are modern barriers stymieing my ability to deliver services and preventing drug prices from remaining affordable. Pharmacy benefit managers or PBMs act like insurance companies for pharmacies, deciding which medications are covered under insurance plans and how much they will pay pharmacies like mine for carrying medications.

Pharmacy benefit managers frequently pocket the difference when they negotiate lower drug prices, inflating drug prices for everyone else as they line their own pockets. As such things go with greedy corporations, these PBMs have chosen profits over people and continuously impose sky-high prices on prescriptions that make medications unaffordable.

Another malfeasance perpetrated by the pharmacy benefit managers comes with the power they have as an oligopoly — and the ability to weaponize this power to dictate which prescriptions pharmacies can carry. Currently, only six companies manage 95% of prescription prices. These six companies are squeezing out Main Street pharmacies to increase profits for their parent companies — all of which are pharmacy chains with a nationwide presence.

To force patients to use their parent companies, PBMs often unfairly negotiate with insurance companies which medications are covered, and provide minimal funding to pharmacies to cover the prescriptions. This, in turn, leads to many small pharmacies being unable to carry specific medications.

Because of pharmacy benefit managers’ greed, my customers and pharmacy have been forced to penny-pinch. Not only are the PBMs forcing me to scramble to make enough money to run my pharmacy, but they have continuously discriminated against individuals across Kansas who require the medications that small pharmacies can no longer afford.

The ludicrous power that pharmacy benefit managers have to dictate prices has denied many independent pharmacies the ability to provide lifesaving services such as flu shots and EpiPens. Further, this excessive power disproportionately harms our older population. PBM negotiations often exploit seniors, driving up costs for supplemental insurance premiums that older Americans on fixed incomes can barely manage.

We need to be warriors against this oppressive system defrauding all Kansans, and thankfully Sen. Roger Marshall is leading the charge. Marshall’s work to drive down prices and reduce the impact pharmacy benefit managers have to control drug prices is a valiant effort. He understands that we are all negatively impacted one way or another by the conduct of PBMs.

How much longer will it be before we fight back against the conglomerates? Please encourage your representatives to defend our communities and put a stop to pharmacy benefit managers’ exploitation so that medications can be more affordable and accessible for all Kansans.

Holly Sebree Gripka is an independent retail pharmacist and owner of The Medicine Store in Basehor.