Pharmacy Benefit Managers Squeeze Independent, Chain Pharmacies

Got story updates? Submit your updates here. ›

Independent and chain pharmacies in Pennsylvania are struggling to stay afloat due to the unpredictable reimbursement practices of pharmacy benefit managers (PBMs). Tom DePietro, owner of DePietro's Pharmacy in Dunmore, likened dealing with PBMs to "sitting down at a slot machine and pulling the lever," as pharmacies never know how much they will be reimbursed for filling prescriptions.

Why it matters

The growing number of pharmacy closures across the state is creating 'pharmacy deserts' where residents have limited access to essential medications and pharmaceutical services. Experts warn this crisis will only worsen unless the state government intervenes to regulate the PBM industry.

The details

PBMs, which manage prescription drug benefits for health insurers, have been accused of using their market dominance to squeeze smaller pharmacies through unpredictable and often below-cost reimbursement rates. This makes it increasingly difficult for independent and even some chain pharmacies to keep their doors open, leading to a rise in closures and the creation of 'pharmacy deserts' in many communities.

• The pharmacy closure crisis has been ongoing for several years in Pennsylvania.

What’s next

Pennsylvania lawmakers are considering legislation to increase regulation and transparency of PBM practices in order to protect independent and chain pharmacies from further financial strain.