In Latest Work with FTC, NCPA President Urges Comprehensive Review of PBM Consolidation

NCPA September 15, 2021

ALEXANDRIA, Va. (Sept. 15, 2021) – National Community Pharmacists Association President Brian Caswell spoke to the Federal Trade Commission during its open meeting today about anticompetitive pharmacy benefit manager issues in the pharmaceutical supply chain. This is part of NCPA’s ongoing efforts to educate and collaborate with the FTC and others on the need for antitrust oversight. NCPA General Counsel Matthew Seiler, RN, Esq., previously addressed the commission as part of its first open meeting in July.

Speaking to the FTC, Caswell said:

“Good afternoon. My name is Brian Caswell. I am president of Wolkar Drug in Baxter Springs, Kan., a small rural community of a little over four thousand in population. Over the past many years I have watched a steady increase of patients being forced or coerced into mail order which, more often than not, is owned by the (pharmacy benefit manager).

“Also, a growing number of restricted medications which are classified as ‘specialty,’ with no clear clinical definition of why it is specialty, are contractually not allowed to be filled by the patient’s preferred pharmacist. Again, the prescription is steered towards the PBM’s own mail order. Some of my colleagues see steering to PBM-owned retail pharmacies too.

“Both of these situations create a fragmented health care system that leads to revenue generation for the PBM, and not to positive patient outcomes. I would like to see the FTC work with the DOJ to do a comprehensive review of the impact of health plan/PBM/pharmacy consolidation and PBM steering practices.”

NCPA’s position is that patients should be able to choose if they want to receive care from their local pharmacist or rely on their mailbox. Despite a pandemic that drove millions of people into voluntary and involuntary quarantine-at-home mode, a national survey in February 2021 found that 85 percent of American adults prefer to get their prescription drugs from a local pharmacist instead of a mail order service, mainly because of the personal relationship.


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 21,000 pharmacies that employ approximately 250,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit