The Problem
The landscape of pharmacies in the United States has shifted in the past generation, as healthcare giants like CVS and Walgreens have mostly displaced local, independent pharmacies. This occurred with the assistance of some unfair advantages, and many of these large healthcare conglomerates continue to use a series of unfair tactics to push independent pharmacies out of the market, including:
- Using their own PBM to under-reimburse pharmacies;
- Using their PBM to steer patients away from independent pharmacies and toward their own; and
- Clawing back reimbursements paid to independent pharmacies.
Nor are the large chain pharmacies necessarily effective at providing care. During the rollout of the Covid-19 vaccine, West Virginia was the only state to opt out of a federal partnership with CVS and Walgreens to distribute the vaccine. The state instead relied on existing relationships with a network of independent pharmacies and outpaced the rest of the country in vaccinating residents of long-term care facilities.[1]
The Solution
State lawmakers could reverse this trend by requiring that pharmacies be locally owned by a registered pharmacist. Such a law would put control of pharmaceutical care in the hands of a licensed healthcare professional rather than a distant corporation.
Model Legislation
North Dakota has required local pharmacy ownership since 1963, and requires that only registered pharmacists may own and operate pharmacies within the state.[2] The sole proprietor of a pharmacy in North Dakota must be a registered pharmacist. As a result of this law, there are no chain pharmacies in North Dakota today.
Notes
[1] Yuki Noguchi, “Why West Virginia’s Winning the Race the Get COVID-19 Vaccine Into Arms,” NPR, January 7, 2021, https://www.npr.org/sections/health-shots/2021/01/07/954409347/why-west-virginias-winning-the-race-to-get-covid-19-vaccine-into-arms.
[2] North Dakota State Board of Pharmacy, https://www.nodakpharmacy.com/pdfs/Lawbook41316.pdf.