This story was reported and written by our media partner the Virginia Mercury.
Virginia Attorney General Jason Miyares and 38 other attorneys general want Congress to pass a bill to prohibit pharmacy benefit managers from owning or operating pharmacies, according to a letter Miyares co-signed Monday.
Pharmacy Benefit Managers, or PBMs, act as intermediaries between health plans, drug manufacturers and pharmacies. PBMs retain rebates and discounts from contracts, leaving consumers and pharmacies unsure how much savings are actually being passed on. That lack of transparency has raised bipartisan concern among Virginia lawmakers.
In their letter, Miyares and other AGs assert that PBMs’ use of pharmacies owned by themselves or their parent company “has exacerbated the problem of manipulated prices and unavailability of certain prescription medications.”
“PBMs were originally created to streamline prescription drug access and reduce costs for patients, but they’ve become powerful gatekeepers,” Miyares said in a press release announcing he’d signed onto the joint letter. “Virginians and Americans deserve better, and I’m fighting to ensure they get it.”
In urging congressional action, the attorneys general argue that banning PBMs or their parent companies from pharmacy ownership would “allow pharmacies to compete on fair terms and create a market that is more accessible to consumers.”
Meanwhile, Virginia lawmakers have already worked on ways to reform PBMs at the state level.
This year, a bipartisan coalition of lawmakers passed a bill that would eliminate health-plan-run PBMs in Medicaid and establish a single state-contracted one. This move, supporters say, would improve accountability, lower costs and help independent pharmacies stay afloat.
More than addressing drug costs for patients, some advocates stressed that reform can help support rural healthcare access and small businesses.
“I know what it’s like to spend $10 to make $5 back from Medicaid,” said Sen. Travis Hackworth, R-Tazewell, who has owned an independent pharmacy.
“We’re the first line,” Blacksburg-area pharmacist Jeremy Counts told The Mercury earlier this year.
He emphasized how local pharmacies serve as key access points for prescriptions, vaccines and physician consultations for rural patients where hospitals are not always nearby. With both national and local pharmacy closures on the rise, Counts warned of “pharmacy deserts” and patient access issues, especially in Southwest Virginia.
After the bill passed the legislature with bipartisan support, Gov. Glenn Youngkin sought an amendment to study the move rather than charge forward with creating a state-run PBM
“We do not need more studies,” Sen. Aaron Rouse, D-Virginia Beach, one of the bill’s patrons, said Wednesday. “This is a true bipartisan bill.”
When the legislature reconvened earlier this month, the PBM bill was among those whose gubernatorial recommendations were rejected. Now Youngkin has until May 2 to sign the bills into law as they passed, or veto them.
