“Pharmacies are as common as fast food restaurants. Today, there are more drugstores in the U.S. than McDonald’s, Burger Kings, Pizza Huts, Wendy’s, Taco Bells, Kentucky Fried Chickens, Domino’s Pizzas, and Dunkin’ Donuts combined, creating a highly competitive environment.” —From the Pharmacy Care Management Association website
Sometimes I have to scratch my head at the extent to which pharmacy benefit managers (PBMs) will go to try to validate their anticompetitive business practices. Take the statement above, one of the PBMs’ justifications for creating restricted pharmacy networks that limit pharmacy patient choice.
Granted, implying that community pharmacies are the health-care equivalent of fast food restaurants is just ignorant in the first place. But it’s also a comparison that argues against limited networks, not for them.
Here’s the PBMs’ argument: Because there are so many pharmacies, they’re all just like fast-food restaurants—there’s one on every corner, and one is really no better than another. Your care is just as good when provided by a PBM-owned mail order pharmacy (and 800 number) as it is by the local community pharmacist you’ve used for years.
So in an effort to squeeze costs out of that marketplace of abundant providers—fast pharmacy?—the PBM selects a group of those pharmacies that’ll meet its pricing demands, and then requires patients to use those “preferred” or “limited” networks of pharmacies – regardless of whether those pharmacies are convenient for the patient. In fact, regardless of the patient at all.
Pharmacy care isn’t fast food, of course. Managing medications isn’t like ordering a double cheeseburger, hold the pickle. And you shouldn’t trust the sketchy middlemen who suggest it is.
PBMs want to choose your pharmacist for you, not based on what’s best for you, but on what’s best for their bottom lines. In fact, it’s one of their big talking points: Letting them choose your pharmacist for you from among all those “fast food” pharmacies could save billions, they say.
But that’s not how it works, and the PBMs’ ill-considered fast food analogy makes that pretty clear.
Just because there are a lot of something doesn’t mean they’re all the same.
Up next: What's the difference?