PUTT Blog | Why Pharmacist Advocacy Matters - And Why We Must Show Up and Speak Up

Let’s cut straight to it: the most powerful voice in healthcare policy isn’t a lobbyist, a trade association, or a polished talking point crafted in a Washington office. It’s a constituent. A real human being who can look their lawmaker in the eye and say, “Here is what your decisions are doing to my community.”

And in pharmacy, that voice is us.

The word “lobbying” actually has a colorful history.  It traces back to the days when someone would wait in the lobbies of legislative buildings and hotels, hoping to catch lawmakers between meetings.  Some stories date back to President Grant, who complained about being cornered in the lobby of the Willard Hotel by people trying to influence his decisions, and the term “lobbyist” stuck. Others point to the 19th-century British Parliament, where citizens gathered in the lobby to plead their case before a vote.  

No matter the origin, the term didn’t start as something shady; it literally meant the people who stood close enough to the power to speak their truth.  And honestly, that’s closer to what pharmacy advocacy is today - we wait, we show up, we speak up, and we try to catch someone close enough to legislative power for a few minutes to tell them what’s really happening.  

The only difference is that now we’re doing it to survive.

Advocacy has never been more critical than it is right now. It’s not the same thing as lobbying, and it’s important that we stop letting others blur that line. Lobbying is the act of asking for a specific vote on a specific bill. 

Advocacy is everything else like educating, informing, organizing, telling the truth, and making sure policymakers understand what is happening in the real world. Most pharmacists who pick up the phone, send an email, or sit down with a legislator are not lobbyists under federal law, no matter how much the PBM industry wants to suggest otherwise.

PBMs love diminishing the advocacy work of independent pharmacies because it makes us sound biased and self-interested - while they quietly spend tens of millions of dollars each year protecting spread pricing, steering, and the chokehold they have over the drug supply chain. Meanwhile, our version of advocacy is taking time away from an already understaffed pharmacy, driving or flying to our state Capitol or D.C. on our own dime, and asking legislators not to let PBMs reimburse us below the actual acquisition cost of the medication.

Those two things are not equivalent in any universe, not morally, not financially, and not structurally.

And here’s another truth that too many people forget: legislators value hearing from their constituents more than anyone else. They will tell you this themselves if you ask. Their most trusted voices are the people who live in their district and who vote in their elections. They rely on those voices. They depend on them. When a pharmacist from their community shows up to explain how their neighbors are being forced to drive 45 miles because the only pharmacy in town closed, that matters more than any corporate briefing they will ever receive. When a patient describes walking away without their medication because a PBM won’t pay the pharmacy enough to keep its lights on, that resonates more deeply than any data slide.

A pharmacist’s story carries a different kind of weight. Why? Because it is rooted in truth and lived experience.

Lobbyists absolutely have an important role to play. Good lobbyists, those fighting on the side of pharmacies, transparency, and patient access, are force multipliers. They help get meetings scheduled, translate policy language, track bills and amendments, identify champions, and keep things moving when we can’t be present in person. They walk the halls every day, they reinforce the message, and they keep the momentum alive between legislative sessions.

But they cannot replace us. Lobbyists can open the door, but only pharmacists can walk through it and deliver the message with the authority of someone who lives the consequences. Only we can explain how policy decisions affect real patients in real time. Only we can describe what it feels like to not take a paycheck for years just to keep the doors open for our towns. Only we can say, “I’ve served this community for years, and I’m telling you my small business won’t survive if PBMs continue to dictate whether we live or die.”

Lobbyists support the work. Pharmacists give the work meaning.

That is why every one of us has to engage. Pharmacy is standing on the edge of a cliff. Small pharmacies like mine and yours are being pushed out of existence. Rural communities are losing their last accessible point of care. PBMs are shaping the system with millions in lobbying, while pharmacists struggle just to keep their doors open one more month. 

If we want something different, we must speak up.

We won’t outspend the PBM industry, and we don’t need to. We have something far more powerful: truth, community, and human consequence. The only requirement is that we show up. Every phone call to a legislator matters. Every email matters. Every story matters. Every meeting matters. When dozens of PBM lobbyists talk about “cost savings,” it’s just noise. But when one pharmacist says, “Your constituents cannot access care because the reimbursement system you allow is killing us,” the room goes still. And in that silence, change begins.

Advocacy is how we bring reality into the room. It’s how we ensure lawmakers understand the stakes. It’s how we remind them that behind every policy, there are actual people, patients, families, and communities whose lives are directly shaped by the decisions made at the Capitol.

If we don’t speak, someone else will. And that someone will almost certainly be funded by a corporation with billions of dollars at stake and zero connection to the patients we serve. Someone who has never stood at a counter late at night trying to get a patient’s insulin covered. Someone whose priority is profit margins, not people.

This profession cannot afford our silence. Our patients cannot afford our silence. The future of community pharmacy, especially rural, independent, historic, woven-into-the-town pharmacy, depends on us raising our voices, telling our stories, and refusing to disappear quietly.

Lobbyists can amplify the message, but we are the message.

And when pharmacists show up and speak the truth, the whole room changes.

Brandi Chane,

PUTT Board member