Belcher tells panel that PBMs are crushing small businesses

NCPA December 2, 2021

NCPA President Michele Belcher, owner of Grants Pass Pharmacy in Grants Pass, Ore., on Thursday told a virtual town hall that massive consolidation has hurt her small business, her patients, and many pharmacies like hers. “It’s almost like the Cignas and CVSs of the world are too big to regulate,” Belcher said at the event, which was hosted by the American Economic Liberties Project and featured White House National Economic Council Director Brian Deese, National Economic Council Deputy Director Bharat Ramamurti, and Special Assistant to the President for Technology and Competition Policy Tim Wu. The event included discussions about President Biden’s Executive Order on Promoting Competition in the American Economy and how it seeks to support the country’s workers, entrepreneurs, and business owners. Participating business and labor leaders, including Belcher, discussed the harms they experience from monopoly power and engaged in a Q&A with White House officials. Belcher explained that her small business is harmed by the market dominance of the three major PBMs. “The three are now vertically integrated with health plans including CVS Health/Aetna, Cigna/Express Scripts and UnitedHealthcare/OptumRx. Together they monopolize 77 percent of the prescription drug benefit market,” she said. “Independent pharmacies have no leverage to negotiate with PBMs and are forced into take-it-or-leave-it contracts if they want access to networks necessary to serve their patients. Even after I accept these one-sided contracts, I am subject to terms that allow the PBMs to steer my patients to their own affiliated pharmacies, opaque financial clawbacks, and discriminatory reimbursement.”