As founder of Bronx Bodegas and Small Businesses, a community resource group for small business owners in the Bronx, and a proud Bronx-based bodega owner myself, I know the many struggles business owners face just to stay afloat. After rebounding from a worldwide pandemic, we still grapple with local crime, labor shortages and volatile health care inflation. As lawmakers in Washington now look to address drug pricing federally, they must consider how proposals aimed at pharmacy benefit managers (PBMs) would negatively impact already-struggling small business communities — both here in the Bronx and nationwide.
Offering staff competitive health benefits is critical to most employers’ success. Small businesses don’t have the bandwidth to navigate the complexities of the health care industry, nor do they have the budget to withstand price fluctuations each time an employee changes their pharmacy.
I need the best employee benefits I can afford at a fixed monthly cost I can predict. That’s why I and so many other small businesses rely on PBMs.
PBMs identify and administer employee prescription drug plans for businesses like mine that don’t have the power to negotiate lower rates with drug companies or create affordable pharmacy networks for employees. Most importantly, they offer different contract types, including spread pricing contracts, which protect employers like me from having to pay different prices for medications filled at different pharmacies.
The importance of price predictability to employers cannot be overstated; 86% of employers say it’s important to have flexibility in how they manage financial risk related to prescription drug spending. The same percentage says it’s important to have access to the full range of options when contracting with PBMs.
PBMs play an important role for small business employers like me, and employers should be able to choose for themselves which contractual agreement works best for their business. Eliminating cost predictability tools like spread pricing would jeopardize the prescription drug benefits offered by more than 1.7 million small businesses and the more than 24 million employees and their families that they cover. When large businesses are included, that number balloons to 42 million employees and their families.
As Congress considers ways to lower the cost of prescription drugs, they must also consider the impact of those changes on small business employers. I hope our lawmakers strongly consider the impacts that anti-PBM legislation would have and learn more about how small businesses like mine rely on these crucial tools.
Francisco Marte is a Bronx resident, business owner and founder of a local small business resource group called Bronx Bodegas and Small Businesses.
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