Pharmacy Benefit Managers, or PBMs, have been blamed for hurting the bottom line of privately owned pharmacies. And those in the industry say it's forcing such small businesses to close their doors. But what if the state made its own PBM?
“Every Virginian should have access to affordable medication, vaccines and a community pharmacy,” Yorktown Republican Senator Travis Hackworth said at a news conference Wednesday morning.
He was announcing a renewed effort to create a state-controlled pharmacy benefit manager, or PBM, to negotiate drug prices and increase reimbursement rates for pharmacies that serve some of Virginia's most needy.
Hackworth said, at one time, he was partial owner of a local pharmacy, and it was the worst business he’d ever been in.
“There’s three people that come in and get the exact same medication. I lose $5 on one, $10 on the other and I make $3 on the other,” Hackworth said. “So, we’ve got to fix this.”
The bill would require Virginia’s Department of Medical Assistance Services to manage prices for Medicaid recipients across the Commonwealth. For Norfolk-based Peoples Pharmacy owner Anna Peoples, it could be the lifeline that keeps her able to serve those in her community.
“We are being reimbursed below our cost,” Peoples said. “So, you can imagine, right now, we’re operating on fumes.”
Gate City Republican Delegate Terry Kilgore is carrying a version of the effort in his chamber. He said Kentucky and West Virginia have already taken similar steps and it’s paying off just over the border.
“It’s a big difference to our local pharmacists,” Kilgore said, before stressing the bipartisan nature of the effort. “A lot of folks talk about the urban, rural divide, but this is a place where we aren’t divided.”
Charlottesville Democratic Delegate Katrina Callsen, who’s also on board with a bill, agreed.
“This is a simple measure that removes layers of fees and red tape and bureaucracy that local pharmacies have to deal with and it in the end will save taxpayers millions of dollars while increasing access to services,” she said.
This is the second time in as many years such an effort has come before the legislature. Those close to the bill say it has more support this year and could at least make it to Governor Glenn Youngkin’s desk.
This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.