Community Pharmacy Can Win and Still Lose

Pharmacy benefit manager (PBM) reform is just getting started, but recent developments have been substantive. From laws barring PBMs from owning their own pharmacies (Arkansas) to growing carve-outs that require PBMs to operate as independent Medicaid contractors (New York and elsewhere) to commercial-plan approaches using cost-to-dispense or minimum-reimbursement floors (Iowa), reform is accelerating—both in the variety of tactics being tried and in the number of “me too” states adopting them. Even at the federal level, which usually lags behind states in pharmacy reform, bills like the Pharmacists Fight Back Act (HR 6609) are actually making it out of committee instead of being sent to endless “studies” and “deliberation.”