Two states down—Tennessee says PBMs can't own pharmacies

"Where you fill your prescriptions could soon be up to you. A bill that passed the Legislature in Tennessee would break up the powerful middlemen who control which pharmacies see you and how much the pharmacies are paid."That lede, in a television news report about new legislation passed April 21 in Tennessee, sums up just how dire the state of pharmacy is in the United States right now. But the passing of Senate Bill 2040/HB 1959 (also known as the Fair Rx Act) in the Tennessee legislature is finally giving independent pharmacists and pharmacy owners reason to hope for a better future. The Act passed with a 24-9 vote April 20, followed by an 86-7 vote in the House of Representatives the following day and now must be signed by the state governor, Bill Lee. Once signed into law, the Fair Rx Act will ban pharmacies which are owned by pharmacy benefits managers and/or insurers from operating in the state. That includes the country's largest pharmacy chain, CVS which is owned by Caremark, one of the largest PBMs. It is expected that CVS will launch a counter-suit that will tie up implementation of the law—the state of Arkansas passed similar legislation last year and a legal challenge by CVS/Caremark has delayed legislators from putting it into action. The National Community Pharmacists Association reports that the PBMs and their allies spent over $7 million and hired more than 60 additional lobbyists to campaign against the ActIn response to the decision, CVS issued a statement claiming that the Fair Rx Act will lead to the closure of about 160 of its pharmacies in the state and reduce access to medication for hundreds of thousands of Tennesseans. The Tennessee Pharmacist Association is on the record as reporting that since 2017—as pharmacy/PBM mergers began to multiply, and PBMs increased their pressure on pharmacy fees and drug costs and boosted their efforts to direct patients to preferred providers and mail order pharmacies—over 600 independent community pharmacies have shut down in the state.

Two states down—Tennessee says PBMs can't own pharmacies

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