NATIONAL GRANGE NEWS

Millions of rural Americans face a devastating health crisis. They suffer from high rates of chronic diseases yet face a severe shortage of accessible healthcare. Many are forced to travel significant distances just to reach the nearest hospital, often driving hours through remote areas. To compound this struggle, rural jobs frequently lack health insurance benefits, leaving countless families vulnerable and unprotected. This combination of high disease prevalence, limited medical access, and inadequate coverage is creating a perfect storm that threatens the very fabric of rural communities across the nation.

What’s even more concerning is that these problems are being compounded by the very companies that are meant to produce savings in the health care system:  pharmacy benefit managers (PBMs). PBMs are making out-of-pocket costs for medicines much higher than they should be, inserting themselves between physicians and patients in making decisions on medications and—particularly disturbing for rural citizens—financially squeezing community pharmacies until they have trouble keeping their doors open.

There has been a lot of talk in Washington, D.C. about PBM reform. Citizens across the country are telling their lawmakers it needs to get done. Just this week, the Grange joined several patients, pharmacists, employers, and others who are negatively impacted by the current PBM practices – we urged Congress to move quickly as this issue affects everyone.

The consolidation of the PBM industry, which has led to just three giant corporations controlling more than 80% of the prescription drug market, is squeezing all our pocketbooks. This is a significant burden for people living in rural areas who, on average, have lower per capita incomes. They are paying higher out-of-pocket costs for the medicines they need just because the PBMs have manipulated the drug pricing system to maximize their profits.

The issues don’t stop at overcharging for prescription drugs. PBMs engage in a practice called “spread pricing,” where they reimburse local pharmacies less than what it costs to dispense medications. This unfair treatment is disproportionately impacting independent community pharmacies, where many in rural America have trusted relationships and rely on their services, rather than the larger chains, which are affiliated with PBMs.  In fact, a recent Federal Trade Commission report found that PBMs are marking up drugs, sometimes by thousands of percent, to generate more profits through their own affiliated pharmacies.

The growing number of independent pharmacy closures is devastating for rural America. In many small towns, the local pharmacy is the community’s primary healthcare resource. These pharmacies can’t remain viable, though, when the system is set up in a way that makes it virtually impossible for them to make a reasonable profit.

Congress cannot allow this impact on local pharmacies to continue. PBM reform bills made their way through Senate and House committees in the last session of Congress, but time ran out on final passage. Congress needs to work together and enact equitable PBM reform as soon as possible.

Last Congress, bipartisan legislation to support rural Americans by protecting the local pharmacies from these predatory practices and removing the incentives for PBMs to push patients toward higher-priced drugs didn’t cross the finish line. This legislation would also ensure that the rebates and discounts that the PBMs are currently pocketing, will instead be passed on to millions of rural Americans.  We need these PBM reform bills to move – quickly – this year.

Not all rural America’s health challenges are easy to address, but this one is. Congress must act now to pass PBM reform that will reduce our prescription drug costs, respect the sanctity of the physician-patient relationship and keep our community pharmacies open for business.