The P.B.M.s…are driving independent drugstores out of business by not paying them enough to cover their costs. Small pharmacies have little choice but to accept these lowball rates because the largest P.B.M.s control an overwhelming majority of prescriptions. The disappearance of local pharmacies limits health care access for poorer communities but ultimately enriches the P.B.M.s’ parent companies, which own drugstores or mail-order pharmacies.
It’s even worse than that. An independent full-service drugstore in New York called Zitomer has been blackballed by the PBMs, and hence many of Zitomer’s customers can’t get reimbursed for prescriptions under their insurance plans. It’s not hard to understand the PBMs’ rationale: there are chain drugstores such as CVS a few blocks away that are owned by the same parent companies who as the leading PBMs.
The FTC, in a report released Tuesday, detailed a number of actions that it said large pharmacy-benefit managers use to boost their profits and increase the spending of the health plans and employers that hired them to control costs. The actions can also lead to higher outlays for patients at the pharmacy counter, the agency said.