Montana pharmacists advocate for House Bill 740 to regulate pharmacy benefit managers

The Montana Senate Judiciary Committee convened on April 1, 2025, to discuss House Bill 740, a proposed measure aimed at addressing the challenges faced by independent pharmacies across the state. The bill has garnered significant support from pharmacists, healthcare providers, and community members who argue that the current practices of Pharmacy Benefit Managers (PBMs) are detrimental to local healthcare access and the sustainability of independent pharmacies.

During the meeting, several pharmacists shared personal experiences highlighting the struggles they face due to complex and non-negotiable contracts imposed by PBMs. One pharmacist recounted the burdensome requirement of signing 40 different contracts with a single PBM, each with varying payment models, which has made it increasingly difficult to operate a viable business. This sentiment was echoed by others who emphasized that the financial pressures from PBMs are forcing many independent pharmacies to close their doors, particularly in rural areas where access to medication is already limited.

Healthcare providers also voiced their concerns about the impact of PBM practices on patient care. An advanced nurse practitioner described the challenges faced by families in rural Montana who must travel long distances to fill prescriptions, often to pharmacies that are not covered by their insurance. This situation not only complicates access to necessary medications but also undermines the effectiveness of telehealth services that aim to provide convenient care.

Supporters of House Bill 740 argue that the legislation will restore fairness and choice in pharmacy care by mandating that PBMs treat independent pharmacies equitably, ensuring they receive reimbursement rates comparable to those of PBM-owned pharmacies. The bill aims to eliminate predatory practices such as "effective rate contracting," which allows PBMs to manipulate payment rates and disadvantage independent pharmacies.

As the committee deliberates on the bill, the testimonies from pharmacists and healthcare providers underscore a growing concern about the future of independent pharmacies in Montana. Many advocates believe that without legislative action, the trend of pharmacy closures will continue, further limiting access to essential healthcare services for residents, particularly in underserved rural communities. The committee's decision on House Bill 740 could have significant implications for the landscape of pharmacy care in Montana, shaping the future of healthcare access for many residents.