Nebraska Pharmacist urges reform to stop community pharmacy closures and PBM issues

In a pivotal meeting of the Nebraska Legislature's Banking, Commerce, and Insurance Committee, the future of community pharmacies took center stage as stakeholders voiced urgent concerns over the ongoing crisis affecting access to medications across the state. The atmosphere was charged with a sense of urgency as committee members and pharmacy representatives gathered to discuss proposed legislation aimed at reforming pharmacy benefit managers (PBMs) and addressing the alarming trend of pharmacy closures.

David Randolph, owner of Dave's Pharmacies and president-elect of the Nebraska Pharmacists Association, delivered a compelling testimony highlighting the stark reality facing community pharmacies. He reported that Nebraska has seen a significant decline in pharmacy numbers, with 69 closures since February 2020—approximately 14% of the total. This trend is particularly devastating in rural areas, where residents often face long distances to access essential medications and healthcare services. Randolph emphasized that the current reimbursement structures from PBMs are unsustainable, forcing pharmacies to make difficult decisions about which medications to stock.

The discussion turned to the complexities of pharmacy acquisition costs, with committee members questioning how to ensure wholesalers remain accountable in a market dominated by a few major players. Randolph expressed his support for LB 198, a bill designed to empower pharmacies to refuse prescriptions when reimbursements fall below cost, a move he argued is essential for their survival. He pointed out that many pharmacies are now unable to stock brand-name medications due to inadequate reimbursements, which ultimately harms patient care.

The committee also explored the issue of patient steering, where PBMs direct patients to their affiliated pharmacies, often at the expense of local providers. Randolph articulated the frustration felt by independent pharmacists who cannot legally steer patients to their own services while PBMs can promote their own interests. This imbalance, he argued, undermines the viability of local pharmacies and compromises patient choice.

As the meeting progressed, the committee members engaged in a thoughtful dialogue about the implications of these issues for Nebraska's healthcare landscape. The urgency of the situation was palpable, with Randolph and others calling for immediate action to prevent further closures and ensure that all Nebraskans have access to the medications they need.

In conclusion, the discussions at this meeting underscored a critical moment for community pharmacies in Nebraska. With the potential for legislative reform on the horizon, stakeholders remain hopeful that meaningful changes can be made to support local pharmacies and, by extension, the health and well-being of the communities they serve. The path forward will require collaboration and commitment to ensure that the lifeline of local pharmacies is preserved for future generations.