As our state continues to combat the effects of the coronavirus, the ability to access high-quality health care is an issue at the forefront of the minds of many Georgians. Independent pharmacists have long played a critical role in providing personalized care to our communities, but because of roadblocks faced by some community pharmacists, too many of Georgia’s patients are now being forced to wait for critical medications. To ensure Georgians can access the care they need, lawmakers must act to protect the important role of community pharmacies, which are more critical than ever amid the coronavirus.
As a clinical pharmacist and the owner of Lily’s Pharmacy in Johns Creek, I know first-hand the important role independent community pharmacists play in delivering high-quality, personal care to our patients. But as pharmacy benefit managers (PBMs), little-known middlemen in the health care system, have gained outsized power and influence, it has become increasingly difficult for community pharmacists to deliver care in a timely manner.
PBMs manage drug benefits for 95 percent of Americans with prescription drug coverage, and most PBMs also own a mail order pharmacy. PBMs, therefore, have the power to financially penalize nearly every patient that chooses to use their community pharmacy instead of the PBM mail order pharmacy. This abuse at the pharmacist care-level by PBM mandates has led to the closing of many locally owned pharmacies. And a lack of patient choice and personal care is having very real consequences, with many pharmacists across Georgia are being prevented from filling patients’ medications because of PBM mandates.
Fortunately, the Georgia General Assembly is considering Senate Bill 313 and House Bill 946, which propose new regulations to provide oversight to PBMs. When the Georgia General Assembly resumes session in June, lawmakers must act to swiftly pass this important legislation and ensure Georgians can receive timely care, including treatments for COVID-19.
For too long, PBMs have operated unchecked, prioritizing their bottom lines over the health and wellbeing of Georgians. Now, lawmakers in Atlanta have the opportunity to enact legislation that will both ensure patients can access the medications they need, when they need them, and protect the important role of community pharmacists.