As Minnesota and the rest of the country gain greater control over the COVID-19 pandemic, the role of independent community pharmacists continues to grow even more important. With vaccine eligibility finally reaching all adults over the age of 16, many of us are helping to administer vaccine doses to help the country reach herd immunity as fast as possible.

Community pharmacists in Minnesota have always been dedicated to caring for patients. Whether operating in densely populated cities or rural towns, we develop an individualized care plan for our patients in coordination with health professionals. Not only that, we are seen as accessible and approachable, and we are close by for patients, located in nearly every community nationwide.

But, as small, local businesses, we are facing mounting pressures that are forcing many community pharmacies to close—for good. With increased competition from large pharmacies and complexities within the pharmacy market, we are losing steam. Moreover, pharmacy benefit managers, the middle-men in charge of controlling prescription drug prices, are squeezing our profits, failing to reimburse us properly and increasing fees.

PBMs steer patients away from their local pharmacies by forcing patients to use the PBM-affiliated pharmacies and mail orders, while offering lower or no copayments. This might prohibit a patient from getting any refills from their local pharmacy unless they pay cash. Patients are losing the right to choose their pharmacy and health care provider.

Unfortunately, independent community pharmacists are forced into bad deals with PBMs that end up hurting our business and customers, limiting access to prescription medications and driving up costs.

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That is why some pharmacies turn to pharmacy services administrative organizations. PSAOs help small pharmacists navigate the administrative process of communicating and working with third-party payers and PBMs. They also raise our voices and interests during one-sided contract negotiations with PBMs. Being part of a PSAO allows me the opportunity to focus on patients instead of getting bogged down by the administrative complexities and unfair practices of PBMs.

For the first time, lawmakers have recognized the skeptical practices of PBMs, with the House and Senate introducing bills to increase transparency and lessen their power and hold over the market. This legislation is a good step toward protecting Minnesota’s community pharmacists and making care more accessible and better for our patients. However, in true form, PBMs are trying to fend off regulation to shield their profits at the expense of pharmacists and our patients.

Unfortunately, in some areas across the country, they have begun attacking PSAOs, claiming that these critical organizations are responsible for lack of transparency within the drug pricing market. This could not be further from the truth.

The reality is that PSAOs have no control over the prescription drug prices consumers see at the pharmacy counter. Instead, they are groups that help independent pharmacists survive in the PBM controlled marketplace and focus on patient care.

Independent pharmacies are incredibly important to communities across Minnesota. We provide the most trusted care to our patients and constantly put them above all else. In order for my colleagues and I to continue being this symbol of health for our communities, we need protection from the dangerous actions of PBMs.

Deborah Keaveny is the owner of Keaveny Drug in Winsted, Minn.

This letter does not necessarily reflect the opinion of The Forum's editorial board nor Forum ownership.