Opinion | Alabama has an immense need for PBM reform

Dear State and Federal Legislators:

Over the past several months, I have sent numerous emails and stories regarding how pharmacy benefit managers are affecting the lives of your constituents. While this happens every single day, I would like to highlight my most recent experience.

Yesterday, I had a call from one of my customers – one of your constituents. She has been going without her inhaler for months because she can’t afford the medication. Even though she has insurance, her copay is still $370 for a one-month supply. Finally, she had saved up enough money to fill the prescription.  

The most concerning part of this conversation was that I could hear her wheezing over the phone. This is a life-or-death situation for her.   

Here is the part that should concern you with absolute urgency: As her pharmacist, I purchased the inhaler from my wholesaler at a very competitive price for a retail pharmacy. My cost was $430. When I filled her inhaler, I sold it for $60 less than I purchased it.  

I, one of Alabama’s many small businesses, lost $60, and your constituent paid $370 out of her grocery and utilities allotment for the month.

There is one entity involved in this transaction that did not lose any money – and made a profit. The PBM’s very purpose is supposed to keep drug pricing fair, but they are slipping our money into their back pockets, and no one is stopping them.  

How much do you think the PBM made? Honestly, who the heck really knows? 

There is zero transparency and accountability.  

Meanwhile, your constituent’s health continues to decline. She could barely breathe. Her access to a pharmacy within 30 miles of her home will soon slip away because we can’t afford to continue to lose money on every prescription filled.  

I basically paid for part of her medication from my own pocket because I care about her.   

Do you care about her, too? 

When I left that day, I stopped by another one of your constituent’s homes. She had a leg amputated and has a hard time getting out of her home. I volunteered to come to her home to give her a flu vaccination, and we chatted for a while before I left.  

It is an honor to care for our community, and I am proud to serve each and every one of them. I am so thankful for the opportunities to be the hands and feet of Jesus.  

It will be a sad day when I am no longer in business because you – those who represent us in Montgomery and in Washington – didn’t take a stronger stance.   

This is urgent. We need help.  

Please take care of your community, small businesses and the people you serve.  

This IS a matter of life or death in some patients.  

It is a growing concern of the constituents that so many legislators – both at the state and federal level – do not seem to have a stronger stance on what is happening to the people.  

Will you rise to the call and protect the vulnerable?  

You know the truth. It’s out. You can’t pretend you don’t.