Fair Rx would restore fairness and quality care to Tennessee’s pharmacy system

This is why KnoxTNToday strives not to delve into any political situation. Every position can be made to sound reasonable and accurate. We recently published an article here provided by a local resident.

We have received the following counter article from Anthony Pudio, CEO of the Tennessee Pharmacists Association.

“The Tennessee Pharmacists Association (TPA) is a Nashville-based nonprofit professional organization founded in 1884 that represents, protects, and empowers pharmacists, pharmacy technicians, and student pharmacists across Tennessee. TPA focuses on advancing patient care,

Richard Ezparza’s April 2 letter to the editor completely missed the mark in the current debate over pharmacy benefit managers (PBMs). (Edited)

Ezparza writes that the General Assembly is making a “huge mistake” with Senate Bill 2040, the Freedom, Access and Integrity in Registered Pharmacy (FAIR Rx) Act, which would ban PBMs from owning their own pharmacies in Tennessee. He argues that the bill would interfere with federal efforts to rein in drug costs, force the closure of CVS Caremark pharmacies, and unjustly intervene in the marketplace.

None of this is true, and it ignores the blatant conflict of interest that allows PBMs to siphon hundreds of millions of dollars per year from Tennessee patients and taxpayers.

First, FAIR Rx would not affect federal drug price reform because it does not regulate drug manufacturing or manufacturer pricing. Rather, it is a pharmacy licensure bill that promotes a fair, accessible pharmacy network.

Second, FAIR Rx does not require PBM-owned pharmacies to close; it simply requires ownership separation. Doing so eliminates the ultimate conflict of interest: PBMs, hired to set reimbursement rules for every pharmacy in Tennessee, also own pharmacies and profit from those rules by underpaying non-PBM pharmacies and keeping those profits for themselves. Under FAIR Rx, these companies must end that conflict of interest and choose to be a PBM or a pharmacy. But they can’t be both.

Third, FAIR Rx is not government overreach. It is the government doing its job — creating the conditions for a fair marketplace where business can compete on a level playing field. As an association leader who represents hundreds of small businesses across the state, I want Tennessee to have a vibrant, competitive economy. But a system where three PBM conglomerates control 80% of the market and use that power to squeeze out local competitors is anything but vibrant or competitive. It’s rigged and unfair.

Ezparza writes that the “pharmacy system is not the problem,” but we have seen mountains of evidence that PBMs are operating unfairly in Tennessee. An audit by the Tennessee Department of Commerce and Insurance caught CVS Caremark reimbursing its own pharmacies significantly more — in one case, by more than 16,000% — than its competitors for the same drugs. Another audit of Express Scripts revealed it collected $30 million from Tennessee employers in a single year by charging employers more for a drug than it paid the pharmacy and pocketing the difference. Does Ezparza expect Tennesseans to ignore these abuses?

While Ezparza worries about CVS Caremark’s threat to close pharmacies if FAIR Rx passes, he says nothing of the more than 600 community pharmacies that have already closed in Tennessee since 2017 thanks to PBM abuses. These are small businesses owned by Tennesseans that provide health screenings, vaccinations, face-to-face counseling and vital specialized services that CVS doesn’t offer.

Fortunately, Tennessee’s remaining independent pharmacies stand ready to serve should CVS Caremark choose profits over patients and close in Tennessee. According to the Tennessee Board of Pharmacy, more than 95% of the 139 CVS pharmacies are within at least 2 miles of another pharmacy. Whatever CVS chooses to do, Tennesseans will still have accessible pharmacy options, including small independents and larger chains like Walgreens, Walmart, Kroger, and Food City.

The FAIR Rx Act is our best chance at bringing fairness back to the pharmacy marketplace. This common-sense reform will kick the fox out of the henhouse by restoring separation and transparency. With Fair Rx, Tennessee can stabilize the marketplace, protect patient choice and ensure quality care for Tennessee patients. It’s time to put patients over profits.”

Anthony Pudlo, Pharm.D., M.S., is CEO of the Tennessee Pharmacists Association.

There will be no comments accepted in reply to this article, as it is solely for the reader’s discernment.