In The News | Letters: Rural residents & veterans need a fair system. PBMs hinder that.
- Aug 27
- 2 min read
Author: Monique Whitney, PUTT Executive Director
Recently guest essayist Rob Maness suggested banning pharmacy benefit managers (PBMs) from owning pharmacies in Louisiana would create disruptions in care for veterans and rural residents. However, this perspective overlooks critical issues with PBM practices and the broader implications for Louisianans - especially veterans.
Mr. Maness’ claim that banning PBM-owned pharmacies would harm veterans and rural residents is misleading. In truth, PBMs often exploit these populations by funneling them into mail-order systems that lack transparency and accountability. TRICARE, the federally-funded health plan for service members and veterans, contracts with a Fortune 15 corporation whose PBM pushes beneficiaries to fill their prescriptions through its privately contracted PBM mail-order pharmacy. Veterans and service members may use the military base pharmacy, but there are only 3 military bases in the state.
Under TRICARE PBM’s plan, basic generic medications like Atorvastatin, which costs an average of $8.47 for a 90 day supply without insurance, costs more than $500 through TRICARE’s PBM owned mail-order pharmacy. In addition, TRICARE’s PBM offers Louisiana independent pharmacies contracts with reimbursements so unsustainably low that very few local pharmacies can afford to join the TRICARE network.
How does lack of access to a local pharmacy benefit veterans and rural residents?
Big box and national chain pharmacies rarely set up shop in rural areas, and patients can not have a relationship with a mail order pharmacy or its call center. Ensuring veterans and rural residents have access to affordable, high-quality care requires breaking up these monopolies, not perpetuating them.
PBMs were originally designed to negotiate lower drug prices and streamline the supply chain. Unfortunately they have evolved over the last few decades into monopolistic entities that prioritize profits over patients.
Mr. Maness’ oblivious suggestion that independent pharmacies “lack the capacity” to fill gaps left by PBM-owned pharmacies ignores the reality that independent pharmacies are often the only healthcare providers in rural areas.
Supporting local independent pharmacies through fair reimbursement policies and transparent practices strengthens the healthcare ecosystem and ensures rural and military patients have access to the medications they need.
Banning PBM-owned pharmacies is a necessary move toward a fairer, more transparent healthcare system that also reverses instead of creates pharmacy deserts. Veterans, rural residents, and all Louisianans deserve a system that works for them, not against them.
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