To keep Kentucky’s independent pharmacies alive, Congress must rein in bad actors | Opinion

From my University of Kentucky College of Pharmacy graduation, to beginning a new job at the Kentucky Pharmacists Association and visiting our federal officials on Capitol Hill, the summer of 2023 has been filled with many exciting first-time opportunities for a young healthcare professional from Hazard.

Growing up, I spent many years at Complete Care Pharmacy, which my family has owned and operated in Eastern Kentucky for 19 years. Being behind the pharmacy counter from such a young age led me to pursue pharmacy school and, upon the passage of my licensure exam, become a proud second-generation pharmacist. It has also given me a unique perspective on the challenges impacting our country’s healthcare system.

Independent pharmacists are special, and many people don’t realize that the job goes far beyond dispensing and filling medications. We’re familiar faces and trusted healthcare advisors in our communities, and oftentimes, when customers walk through our doors, we know their names, their families and their individual healthcare needs.

But the more I’ve studied and trained in the profession, the more I’ve realized that the patient/pharmacist relationship is under threat. Our profession is facing serious challenges because of largely unknown middlemen in the drug pricing system called pharmacy benefit managers, or PBMs. If we don’t do something about them soon, the local community pharmacies that people trust may become a thing of the past.

Originally intended to negotiate lower prescription drug costs for patients, PBMs have instead become a major barrier to care. Today, the three largest PBMs control 80% of the market, dictating which medications are offered, where Kentuckians can access them, how much they will pay and how pharmacists are reimbursed for our services.

PBMs preach cost savings but the reality is that because they operate with almost no oversight, they are free to drive up costs by engaging in harmful practices like spread pricing. This is the technical term for when PBMs charge patients more than the actual cost of a medication and pocket the difference.

Many PBMs are also vertically integrated with health insurance plans and chain pharmacies, giving them power to steer patients away from community pharmacies in favor of their own, mail-order pharmacies even if it’s not the safest, most affordable option.

Without much needed reform, PBMs will continue to find new ways to increase their profit margins at the expense of patients, providers and taxpayers. Even worse, it could leave Kentuckians without a local, trusted healthcare advisor as many community pharmacies will be forced to close their doors.

This month, I had the opportunity to take my concerns to Washington, D.C. and engage in meaningful conversations with Kentucky’s congressional delegation. I was proud to share my story of being a second-generation pharmacist and advocate for PBM reform policies that would create more transparency in healthcare and help community pharmacies, like my family’s, thrive for years to come.

Fortunately, lawmakers are hearing our concerns loud and clear. Kentucky’s own Congressman Brett Guthrie, chair of the Health Subcommittee on House Energy & Commerce, and Congressman James Comer, chair of the house Oversight Committee, are working hard to rein in PBMs’ profit-driven role in our healthcare system and ensure that patients can afford the prescriptions they rely on.

While I’m grateful for their bold leadership to address transparency in healthcare, it is only the tip of the iceberg. There is much more work to be done to ensure Kentuckians are truly getting the best deal on their prescription medications.

I’m proud to see two of Kentucky’s elected leaders in Washington working so diligently to address these important issues. And I’m grateful that members of our state legislature are doing the same.

I look forward to continuing to use my experience in independent pharmacy and at the Kentucky Pharmacists Association to be a voice for patients and pharmacists alike, advocating for a healthcare system that puts patients over profits. Because at the end of the day, Kentuckians deserve a healthcare system that works for, not against, them.

Taylor Williams is an Executive Fellow with the Kentucky Pharmacists Association and a second-generation pharmacist from Hazard, Ky.