Tennessee's top lawmakers Friday said they hope legislation adopted in the General Assembly this year will effectively limit pharmacy benefit managers from unfairly penalizing independent pharmacists from dispensing drugs across the Volunteer State.
To the applause of pharmacists gathered in Chattanooga this weekend for the annual Tennessee Pharmacists Association convention, Tennessee Lt. Gov. Randy McNally and House Speaker Cameron Sexton said the bill adopted by the General Assembly earlier this year will ensure that patients have access to their pharmacy of choice and that pharmacies will receive adequate compensation for medication products and their dispensing.
"We just want a level playing field and to give consumers the chance to get their prescriptions filled where they want," Sexton said. "I think this legislation gets us to a point to support pharmacists in our state against the unruly practices of PBM-owned (pharmacy benefit manager-owned) pharmacists who are doing things for their own pharmacies and paying at a higher level than they are for the other pharmacists across our state."
Pharmacy benefit managers, which include such pharmacy giants as CVS Caremark, Express Scripts, UnitedHealth and Humana Pharmacy Solutions, were formed to help major employers and insurers manage and control their drug costs by directing patients to preferred dispensers of drugs.
Phillip Johnson, the legislative chairman for the Tennessee Association of Health Underwriters, said the new legislation designed to help independent pharmacists raises the dispensing fee that is tacked on to prescription drugs by pharmacists from $2 per prescription to anywhere from $8 to $11.49 per prescription.
"Tennessee already has the third-highest prescription drug cost per household in the nation, totaling an average of $6,007," Johnson said earlier this year in opposition to the new pharmacy benefit manager regulations.
In a phone interview Friday, Johnson repeated that the new bill is likely to push up consumer costs, or at least limit some of the ability of pharmacy benefit managers to try to cut drug costs.
But pharmacists complain that pharmacy benefit managers direct pharmacies they own, such as CVS drug stores, and the pharmacy benefit managers keep much of the savings they tout.
McNally said this year's bill was adopted after an earlier attempt to protect independent pharmacists from being shut out by pharmacy benefit managers didn't produce much enforcement action by the Tennessee Department of Commerce and Insurance, which oversees insurers and benefit managers. The new law, which will take effect on Jan. 1, is more specific in blocking pharmacy benefit managers from steering or directing patients to a particular pharmacy or under reimbursing pharmacies for drug purchases.
"We came back this year and really cleaned things up with this legislation and left no room for error as far as enforcement," McNally said.
Sexton said in one meeting with insurance regulators in the state about the pharmacy benefit manager regulations, "we finally had enough and I point blank asked them who they work for. Do they work for the PBMs (pharmacy benefit managers) or do they work for the people of Tennessee?"
McNally said having more community pharmacists and more consumer options for buying drugs provides better competition and service for Tennesseans.
Tennessee pharmacists, on average, were paid $115,400 a year in 2021, or more than twice the $49,330 average annual pay for all Tennessee workers, according to the U.S. Bureau of Labor Statistics.
McNalley, who previously worked as a hospital pharmacist in Oak Ridge, said being a pharmacist requires a lot of specialized chemistry and drug training and they play a vital role in providing health care to most Americans.