Proposed state legislation seeks to address the dire Oregon pharmacy landscape by giving more power to drugstores when dealing with pharmacy benefit managers, or PBMs. These companies, created to help customers more easily navigate buying medicine, act like middlemen between pharmacies and insurers. A PBM can decide how much a drugstore is paid for filling a prescription.
Medicap Pharmacy staff pharmacist Ryan Baker in December 2021 works on prescription orders at this independent pharmacy in Talent, Oregon.
April Ehrlich / OPB
But pharmacists say that reimbursement is often too low, contributing to drug stores losing money and closing.
Jeff Errol, CEO of Cascadia Pharmacy Group, which includes seven pharmacies in Southern Oregon, said reimbursement rates by PBMs have been “egregious.”
“It’s taken a toll on the pharmacies,” Errol said.
Oregon has lost hundreds of pharmacies in the last decade and now ranks last in the contiguous U.S. for pharmacy access, according to the Oregon State Pharmacy Association.
Although PBMs served a purpose when created, Errol said, those companies now regularly underpay pharmacists for the sake of profit.
“And that’s where the problem arose,” Errol said. “Greed knows no limits.”
House Bill 3212 would give more bargaining power to drugstores when dealing with PBMs. For example, pharmacists would no longer be required to provide services if the reimbursement is less than the cost of those services. Errol said pharmacies are often forced to fill prescriptions at a loss
The legislation would also require a dispensing fee determined by the Oregon Health Authority.
Opponents of the bill say the new rules would increase prescription drug prices.
“Regence would see several million dollars in new drug costs, a large portion of which would be directly borne by members through their cost share, and all of which would be paid by members in premium increases,” according to testimony by Mary Anne Cooper with Regence BlueCross BlueShield of Oregon.
Justin Low with the Association of Oregon Counties testified against the measure, pointing to the proposed dispensing fee as a problem.
“As a result, counties — as large public employers that provide health insurance to our employees — would face higher insurance premiums,” Low said.
Justin Higginbottom is a reporter with JPR. This story comes to you from the Northwest News Network, a collaboration between public media organizations in Oregon and Washington.
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