BRANDON, Fla. (CW44 News At 10) – In Tampa Bay, there are close to 100 independent pharmacists that are at risk of shutting down because of lack of drug pricing regulations. Independent pharmacies are worried that this will cause pharmacy deserts and hundreds of millions of dollars in losses in Florida’s economy.
The Local Dilemma
Third generation pharmacist, Basil Noriega is keeping his family’s legacy alive everyday as he heads into work. He operates Bill’s Prescription Center, one of the longest running pharmacies in Tampa Bay, established in 1956. “We were one of the first pharmacies in Brandon. Brandon was just kind of a hole-in-the-wall place at the time,” said Noriega. “One of the things he noticed was that the pharmacy that was in Brandon at the time was a little tiny shack. [My father] kind of found his niche. My great-great-grandfather was also a pharmacist,” said Noriega.
But with the threat of pharmacy benefit manager reimbursements, that legacy could soon be lost.
“It started about 10-15 years ago, we started seeing these pharmacy benefit managers coming in and really affecting the reimbursement rates and increasing the cost of medications per patient. The past five years, it’s gotten so bad where you’re seeing independent pharmacies across the nation closing…everyday,” said Noriega.
Think of PBMs as the middle men. They were created to help negotiate drug prices between “big pharma” and pharmacies. They pool money from contracted pharmacies to amass purchasing power, then negotiate rates and rebates with the pharmaceutical companies. Opponents of PBMs contend a greater incentive exists to favor high-priced drugs over cost-effective counterparts due to drug rebate calculations. The issue here: there are no regulations in place stopping PBM’s from increasing prescription costs.
“It all boils down to: people are paying more, the government is paying more – for what? It’s for companies behind the scenes to make money,” said Noriega. “I’m getting one right now.” Noriega pauses as he’s interrupted by a notification of reimbursement. “So yeah this [prescription] costs us $152 and they’re paying us $60… So.”
Of 123 independent pharmacies surveyed, 98% are full MEDICAID providers. 61% of those pharmacies plan to discontinue MEDICAID if below-cost reimbursements continue. Noriega says, without change, we run the risk of losing these small businesses.
Resolving The Issue With Policy
“You’re going to create a monopoly where CVS and Walgreens are going to be the only ones that will be able to give you prescription drugs and then they’ll start to dictate the prices,” said Jackie Toledo, (R) member of Florida House of Representatives.
Representative for District 60, Jackie Toledo proposed House Bill 961 in December 2019 that would crack down on PBMs and subsequently lower healthcare costs. “Nothing happened. Another year goes by where we’re not dealing with this issue. So next year, maybe I’ll start with the smaller piece of it,” said Toledo.
But the fight is not over. In fact, representative Toledo is working with advocacy groups like PUTT (Pharmacists United for Truth and Transparency) and SPAR (Small business Pharmacies Aligned for Reform).
“It’s costing all of us money and minimizing our access to these prescription drugs,” said Toledo. “You know, when I got into it I started really getting upset with what’s happening. I’ve read books, I’ve seen data. If we don’t stop this from happening it’s going to continue to have an adverse effect on our healthcare system.”
Both PUTT and SPAR Non-Profits have now developed a statewide coalition of advocates with a goal of preserving patient access and keeping drug costs affordable.
CW44 News At 10 will continue to follow this story as it develops.
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