Steil, thanks very much. >> Thank you.
>> On health care, we continue our coverage of
prescription drug prices, which continue to climb for
patients and pharmacies, while coverage of them
continues to plummet. In RX, uncovered "Here& Now",
producer Marissa Wojcik examines the complex systems
driving these trends. This week, we look at the impact
on pharmacies, both big and especially small, and why
their disappearance is hurting patients.
>> We have been in business for over 70 years.
>> The local drugstore was once upon a time a staple in
communities across the country.
every month and it's scary, and we think about how how
long can we last? >> Today, whether it's the
local drugstore or a chain pharmacy, the brick and
mortar presence is dying. >> The feasibility of having
an independent pharmacy is becoming very challenging.
>> Nicole Schreiner is the new CEO of Streu's Pharmacy
in Green Bay and president elect on the board of the
Pharmacy Society of Wisconsin.
>> We get up in the morning because we want to truly
help serve our patients. >> Alongside her commitment
to the mission, she takes on her new dual roles in one of
the most challenging times for pharmacies. From 2010 to
2021, 30% of drugstores in the US closed. Last year
alone, 2300 pharmacies closed, half of them being
independent or mid-sized businesses.
issue for patients. We oftentimes talk about in
rural areas. You know, patients having to travel,
you know, perhaps 20 miles to a find a pharmacy that
would be able to provide their medications. And but
we're having that even in urban city areas.
>> For some, a visit to the pharmacy is a quick step.
Picking up 1 or 2 prescriptions. But for many
patients, it's much more than that.
>> Your pharmacist a lot of times will be a critical
component of your medical care team.
>> Senate President Mary Felzkowski authored
legislation trying to help local pharmacies keep their
doors open. >> We saw our small,
independent pharmacy starting to go out of
business in rural Wisconsin. When it may take months for
a patient to get a clinic visit. Pharmacists say they
bridge that gap. Available for anyone to walk in and
ask questions at any time. And prevention leads to
healthcare savings. >> For patients with asthma.
We did a study with the Pharmacy Society of
Wisconsin and showed that when they sat down with a
pharmacist on two 30 minute interventions, that they
reduced the number of ER visits, the number of
hospitalizations. These things are making a
difference in overall reducing health care dollars
spent. >> Like with most retail
stores, it'd be reasonable to assume that internet
sales are putting pharmacies out of business. And while
mail order and online retailer giants like Amazon
do compete with on site service advocates, diagnose
a much deeper and chronic issue.
>> PBMs pharmacy benefit managers have been around
for a very long time. >> Pharmacy benefit managers
or PBMs act as middlemen between drug manufacturers,
wholesalers, providers, insurance companies and
pharmacies. >> And they've monopolized
and they've gotten in between prescribers and the
delivery of drugs, driving up the cost of drugs instead
of lowering them. >> The three largest PBM
companies accounted for 80% of prescription claims last
year. >> They'll claim that they
negotiate with drug manufacturers and
prescription drug costs. However, despite these
claims, PBMs regularly inflate what patients pay
and force pharmacies to operate a loss.
>> It's become very powerful, and independent
pharmacies like myself have no negotiating power
anymore. With these PBMs. >> The impact of PBMs that
PBMs are having on rural pharmacy is staggering.
>> The legislation takes aim at a number of their
practices, including not allowing patients to fill
prescriptions at certain pharmacies.
>> PBMs dictate where prescriptions can be filled.
>> Punitive audits against pharmacists who inform
patients of lower cost options.
>> What to charge a patient. >> And perhaps the biggest
of all for pharmacies. >> What they will reimburse
a pharmacy. >> Reimbursing the price of
medications below cost. >> And when they'll pay the
pharmacy. >> Forcing them to take
losses. At a Senate health committee hearing, numerous
local pharmacies attested to this issue.
>> My pharmacy is currently operating in the red right
now solely due to PBM reimbursement rate margins
estimated to PBMs have increased by 46%, and during
the same time, margins to pharmacies have decreased by
47%. >> The contracts have become
basically take it or leave it. They've continued to
erode year after year after year, and it's estimated
that independent pharmacies, depending on your particular
location in the country, can have anywhere from 20 to 40%
of their claims are actually reimbursed below cost.
>> But not all health industry experts agree.
>> We believe all these provisions will be
associated with increased costs to health plans and
sponsors. the bill, such as health
insurers, say it will increase prices for health
plans. Employers and patients. The exorbitant
cost of drugs, they say, begins with the drug
manufacturers. >> Instead of taking away
the few tools that health plans and employers use to
address ever increasing drug prices, the legislature
should focus on fixing the market distortion caused by
drug manufacturer pricing schemes.
hard on showing them through data from other states that
have allowed that have the same legislation, where it's
actually lowered the cost of health care.
>> Whatever the cause, the impact on the patient is
real, like the ability to obtain diabetes medications.
>> GLP ones, those. Some pharmacies are just choosing
not to carry them because they get reimbursed below
their cost. >> Or having your insurance
accepted. choosing not to carry
particular plans because of the poor reimbursement.
>> Every day in my pharmacy, I witness patients facing
exorbitant co-pays, sometimes exceeding $500 for
medications they cannot afford. These patients are
confused. They're overwhelmed, and they're
forced into impossible decisions about their
health. >> For a patient having to
fill prescriptions at multiple pharmacies, the
consequences can cost them their lives.
>> Recently, when learned that they had a
duplicate prescription that was at another pharmacy from
a different doctor. If they had gone home and taken
both, they would have needed emergency care and it could
have been fatal. >> From the extremes of the
pandemic to the work they do every day, independent
pharmacists say their commitment is to their
community. >> What happens if PBMs
continue to drive us out of business? Who will step up
during this crisis? Who's going to be doing seven day
a week testing? Who's going to deliver meds late at
night for a hospice patient who's going to get a call at
2 a.m? I just got that last week. It won't be a mail
order pharmacy in another state that's doing that.
>> Being able to provide that service to patients and
to be part of making sure that they are taken care of,
is really what we want to ultimately do.
>> Reporting from green Bay, >> Reporting from green Bay,