US EditionIllinois patients, pharmacies struggle as PBMs drive up costs, limit access (copy)
- In Illinois, lawmakers and Governor Pritzker are addressing concerns about pharmacy benefit managers and their impact on drug costs and access for patients, particularly those economically vulnerable, as well as the viability of independent pharmacies.
- Independent pharmacies contend that an increasingly complicated reimbursement system, influenced by PBMs, makes it difficult for them to compete, sometimes leading to closure and leaving communities without a local pharmacy.
- Heather Anderson, a 47-year-old Springfield resident, received a package containing her prescribed medication Stelara that was not properly chilled, and an Accredo representative, a subsidiary of the PBM Express Scripts, initially advised her to use it anyway, causing her distress.
- Governor Pritzker stated during his State of the State address in February that high drug costs are making medications unaffordable, and Dave Falk, who owns 10 independent pharmacies, noted that PBMs' payment methods have caused a loss of business.
- Proposed legislation, such as SB 2385 in Illinois and SB 252 in Alabama, aims to curb PBM abuses by stopping steering, mandating fair reimbursement, requiring annual pricing reports, and prohibiting certain fees, with the goal of helping both pharmacies and patients.
13 Articles
13 Articles
Letters for March 28: Governor’s decision not to sign pharmacy bill is a ‘missed opportunity’
Pharmacies As a Virginia pharmacist, I see the challenges facing pharmacies as they try to survive in an increasingly fragmented and complex reimbursement system that is only made more so by the pharmacy benefit managers (PBMs) that control it. The governor’s decision to not sign the Save Local Pharmacies Act (HB2610 / SB875), and instead request an evaluation be completed by the Department of Medical Assistance Services, is a missed opportunity…
Legislators work to give Montana pharmacies 'a fighting chance'
This legislative session, Rep. Marta Bertoglio introduced House Bill 740 to help Montana’s pharmacies stand up to pharmacy benefit managers (PBMs). Decades ago, these industry giants started filling a legitimate need in the processing and negotiating of prescription drug insurance…
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