Community pharmacists need our help

Building on a previous op-ed I shared, we MUST bolster community pharmacies in NC. They are on the frontlines of vaccine distribution and they are under attack from corporate interests.

To the Editor:

The Biden Administration’s “Path out of the Pandemic Plan” continues to reinforce the crucial role of pharmacists throughout North Carolina and the country. Independent, community pharmacists have been on the front lines since the first days of this pandemic, providing extensive testing, administering vaccines, and acting as caregivers at a time when our healthcare system was overwhelmed.

Independent pharmacists are up to the challenge and are committed to defeating COVID-19. As business owners, we need the same support that other small businesses have received during the pandemic. It’s tough running a small business, even one as essential as an independent, community-based pharmacy. For help we often turn to pharmacy services administrative organizations (PSAOs), which play a critical role supporting us behind the scenes. And their efforts help us keep our “eye on the ball,” providing the care patients need and deserve and not spending inordinate time on administrative work.

Independent pharmacies must comply with incredibly burdensome regulations and paperwork from both state and federal agencies and our healthcare supply chain partners. And while this oversight is often necessary, the red tape keeps us stuck in a backroom, managing inventory, recording prescription data, communicating unnecessarily with other healthcare workers, among other things. We turn to PSAOs to relieve our bureaucratic load, taking us out of those backrooms and putting us where we belong – at the pharmacy counter assisting our patients.

Perhaps the most important role of PSAOs is managing reimbursements and negotiations with pharmacy benefits managers (PBMs). PBMs are giant middlemen within the prescription drug market that make the lives of independent pharmacists harder and healthcare for patients less accessible. They are in charge of prescription drug benefits, determining reimbursement rates for the prescriptions we administer to our patients. With their size and influence, negotiations between PBMs and independent pharmacies are routinely one-sided, and we are sometimes forced to sell necessary medicines at a loss. PBMs have such influence over the market that they represent an existential threat to the viability of independent pharmacies and the community-based pharmacy business model.

To best fight the new wave of coronavirus cases, community pharmacies will need to keep testing, administering vaccines, and providing all types of care to our patients. But we won’t get where we need to be without community pharmacists’ ability to do their jobs. I hope lawmakers will reject any false PBM claims as they consider ways to implement more transparency within our prescription drug market. And with the help of President Biden’s new plan and our PSAO partners, independent pharmacies will be able to fulfill our role and protect our communities.


Eddie Cash
Doctor of Pharmacy, Campbell University and practicing pharmacist from 1994-2009