Customers all around Oregon for hours at pharmacies and waiting weeks for prescriptions to be filled.
One reason for the wait times is staffing shortages. Another is a lack of locations 鈥� Bi-Mart announced recently that it鈥檚 .
Kevin Russell spent 28 years working in community pharmacies and is now the Central Oregon Regional Director on the Oregon State Pharmacy Association board.
Russell told OPB that intermediary companies called have too much control over the prices of prescription drugs, and that causes a ripple effect.
鈥淧BMs were just someone that processed claims on the behalf of insurance, but they have grown and consolidated throughout the entire pharmacy industry, to the point now that they have a complete oligopoly on the pharmacy marketplace,鈥� Russell explained.
鈥淪ince the pharmacies can鈥檛 change what they pay for drugs, and they can鈥檛 change what they鈥檙e getting paid for drugs, the only thing they can do is cut back their expenses. And the only controllable expenses they have really is staffing.鈥�
Russell told OPB that a shift in the industry started around 2017, noting there 鈥渨ere massive layoffs of pharmacists throughout the country.鈥� With COVID-19 began to spread worldwide in early 2020, the pharmacy industry, already under pressure, faced more strain. The pandemic 鈥渏ust kind of made things worse,鈥� Russell said.
The pandemic also brought out the best in pharmacies, Russell said. 鈥淸Pharmacists] stayed at work, they worked long hours. They spent the extra money that was necessary to take care of patients and deliver drugs. They did all those services, but that was extra time without any extra staffing that they just didn鈥檛 have鈥� now they鈥檙e doing vaccinations鈥� doing a wonderful job with that, but it鈥檚 just too much. It鈥檚 more than they can possibly do.鈥�
While pharmacy staffs are squeezed across the country, Oregon鈥檚 problem has another layer with the that recently went into effect.
Here鈥檚 how it works, according to Russell: Under Oregon law, a company鈥檚 revenues are taxed instead of its profits. For a typical pharmacy that has millions of dollars in revenues, the wider company may not actually make a dime of profit out of that pharmacy.
The situation becomes having high sales, but a low-profit margin, similar to grocery stores.
There are several systemic issues at play that are making it hard for people in Oregon and around the country to fill prescriptions. Russell says the main long-term solution would be reform of Pharmacy Benefit Managers. But, in the short term, Oregon can bring change.
鈥淭here are already existing laws on the books, in the state of Oregon, for PBMs,鈥� Russell said. 鈥淔or example, PBMs can鈥檛 pay a pharmacy below their cost of drugs. Those are currently not being enforced by the state of Oregon. So, if we can get some enforcement behind those and at least get some of that relief from that, that will help. And another thing that can be done that the legislature can do is just exempt prescription drugs from the [Corporate Activities Tax]. That is something that can be done quickly in the next session. So those are things that can be done from a legislative and state government point of view.鈥�
So what can you as a pharmacy customer do to help address the growing issue?
鈥淔rom a people point of view, I would suggest complaining to your employer and insurers,鈥� Russell said 鈥淭he PBMs only answer to one person, and that is their client, their insurer, or their employer group. And they鈥檙e obligated in their contracts with those insurers and employers to provide access to prescription drugs for their covered patients. If enough people complained to the insurers and employers, they鈥檙e going to go back to the PBMs.鈥�
Sage Van Wing contributed to this story.
Copyright 2021 Oregon Public Broadcasting. To see more, visit .