On Monday, Rep. Peter Welch. D-Vt., plans to introduce legislation next week that aims to create a “level playing field” between independent pharmacies and bigger, national organizations.
Welch is planning to introduce two pieces of legislation, both involving the pharmacy benefit managers (PBM), who administrate government, private and company health plan benefits.
One bill would prevent PBMs from retroactively changing the price of a particular drug, sometimes months after it’s sold, requiring the pharmacy to pay the drug company more money.
The other bill would prohibit PBMs from excluding small, independent pharmacies like the Rutland Pharmacy from joining preferred pharmacy networks that fill prescriptions for Medicare patients.
Welch spoke at the Rutland Pharmacy on Monday along with Jeff Hochberg, director of the Rutland Pharmacy, Kevin Mullin, who was once a Rutland County state senator and now serves as the chairman for the Green Mountain Care Board, and Michael Fisher, chief health care advocate for Vermont Legal Aid.
Welch said the bills are bipartisan and he’s co-sponsoring them with Rep. Morgan Griffith, R-Va.
“Community pharmacies are essential to the well-being of Vermonters. They’re essential to the well-being of Americans. Our health care system is getting incredibly complicated and in many cases, a little too impersonal,” he said.
Welch said a local pharmacy can have a personal relationship with the patient.
Local pharmacies are being excluded from some pharmacy networks, which could jeopardize their finances and close them down in the long term.
“Morgan Griffith and I are introducing legislation that would allow our community pharmacies to participate in this program. They’d compete but they’d have the option to participate in it in order to continue to give this service to their patients,” he said.
Welch said the second bill would stop what he called “really an astonishing practice.” Welch said he was shocked when pharmacists showed him the records of drug manufacturers reducing a drug price months after the drug has been sold at the price set by the company.
“That’s not possible. Morgan Griffith and I are saying that’s not just impossible, that’s wrong and if our legislation passes, it’s going to be illegal,” Welch said.
Welch said that while members of Congress sometimes had “fractious” relationships, there are areas where people can work together. He said the high cost of prescription drugs was something that could be a problem in areas where voters are conservative or liberal.
“Morgan Griffith is a very conservative Republican but the people of his district and the pharmacists of his district face literally the same challenges that we see here. That’s what unites us and gives me some confidence, we’re going to get this legislation passed,” he said.
Hochberg said Vermonters had pride in a deep sense of community.
“Pharmacists do more than just dispense pills. They provide guidance and information on medication therapy, disease management, other health solutions. They administer vaccinations and help patients navigate the complexities of our health insurance system,” he said.
With changes in the health care system, Hochberg said it was important to preserve access to local pharmacies, and to preserve patients’ choice of pharmacist.
Fisher said Vermont Legal Aid runs a helpline.
“The key thing we do is connect (callers) to trusted providers. … At this pharmacy, and pharmacies like it across the state, Vermonters are turning to trusted providers to get the help they need,” he said.
While Welch said he hoped other members of Congress would support the legislation, he admitted he was “totally worried” about “Big Pharma” pushing back.
“We all pay lip service to small business and most people who live in small communities, they actually mean it because there is a personal interaction. But we are fighting powerful forces whose goal is bottom-line profit, high executive pay, and incidentally, if that person on the phone gets your name right, that’s great, but service is the last thing on their minds,” he said.