Jennifer Shannon, Pharm.D, BCPS
Johns Creek, GA
I am a Clinical Pharmacist and owner of Lily's Pharmacy of Johns Creek.
At Lily Pharmacy we serve our patients as their trusted pharmacy. We know our patients’ medical histories and what concerns they have for their health. As a pharmacist, all I ever want to do is provide care for the patients of my community. Today, it is now more difficult financially and professionally to continue this goal.
I am most concerned for my patients being able to affordably access life-saving specialty medications. Too many patients have been forced to spend weeks or days waiting for medications, leading to gaps in care, medication resistance, and poor disease state outcomes. Over time, pharmacy benefit manager (PBM) corporations have taken over the entire role of the pharmacist, and local pharmacies have been replaced by mail order pharmacies. At mail-order pharmacies, pharmacists are behind 1-800 numbers and prompts, all the while turning medications into retail commodities with little regard for the patient. They have complicated the dispensing of a patient’s treatment regime. For example, PBMs have mandated that a patient’s chronic medications are ordered through a mail-order pharmacy, while acute medications are filled locally. Through lack of reimbursement and abuse at the pharmacist care level by PBM mandates, locally owned and trusted pharmacies continue to be closed because they cannot overcome the barriers that get thrown at them.
Every day PBMs continue to strip pharmacists of the patients they care for through their mandates and steering. SB 313 and HB 946 aim to preserve patient choice, improve transparency, and provide oversight to PBM companies that have flown under the radar for too long at the expense of patient care and poor health outcomes for patients.
Recently, a patient who had a massive heart attack and was in heart failure at discharge was recommended to be placed in the care of our pharmacy. When we went to process the medications, his PBM mandated that ALL medications require a prior authorization, no matter what they were for and regardless of the urgent need. If the prior authorization was approved, they would then ship the medications, potentially delaying care by a week or more. That was absolutely horrifying, and I could not believe my ears. To prevent further medical stress to the patient, we provided the medications at cost so that he could access them immediately, bypassing what could have led to a hospital readmission. I encounter barriers daily that jeopardize the health of my patients. I feel positive that the more we bring these harmful PBM policies to light, the more we can improve care for all Georgians at the pharmacy level.
Read the latest from Dr. Jennifer Shannon in NorthFulton.com.