Triad pharmacies hope House Bill 246 can keep doors open

(WGHP) — North Carolina House Bill 246 is currently in limbo. What happens with it will affect how people get their prescription medications.

It was passed by the North Carolina House over a year ago and then passed the first reading in the North Carolina Senate. It was then referred to the rules committee and has been there since May 2023.

Locally owned pharmacies want the bill to pass so big companies can’t dictate where you get your prescriptions filled.

“We wanted our community to have the same pharmacy experience that we had when we were growing up,” Pharmacist Keith Vance said.

Vance and his wife opened Lewisville Drug in 2005 with an emphasis on a personal touch.

“Where the pharmacist knew you. When they walked in the door, they called you by name. They didn’t know you by just health conditions. They knew about your family, your do and just being a big part of the community,” he said.

Vance says the impact of pharmacy benefit managers is hurting local pharmacies like his, which are often referred to by the acronym PBM.

PBMs are the middleman between pharmacies, insurance companies and drug makers.

“PBMs are kind of the shadowy part of the healthcare system,” Vance said.

They determine which drugs are covered by insurance, how much patients pay out of pocket and payments to pharmacies.

The three largest PBMs are probably familiar to you: CVS Health with Caremark, Cigna with Express Scripts and United Health with Optum RX.

There’s a lot of overlap, so a company like CVS Caremark is more likely to make you only use CVS pharmacies.

“A pharmacy benefit manager is basically an extension of an insurance company,” said David Price of Stanleyville Pharmacy.

Price says with so much of the market dominated by those big PBMs, the little guy being cut out

“We just simply aren’t paid enough to even cover the cost of a lot of drugs anymore,” Price said.

House Bill 246 would ensure patients can still pick their own pharmacies and give the North Carolina Department of Insurance teeth to enforce rules on PBMs as well as mandate fair reimbursement for all pharmacies and not just for the ones owned by the PBMs.

“Senator Phil Berger … and Senator Rabon … are the people who have the power to move it to the floor, and I am just hoping they’ll do that,” Price said.

92 independent pharmacies have closed in North Carolina since 2022 through April of 2024. On a larger scale, you’ve probably seen Walgreens closing 25 percent of their stores. Unlike CVS, they do not own a PBM.

We reached out to Berger’s office to see if the bill might come to the floor but haven’t heard back yet.

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