AILSA CHANG, HOST:
There's a lot about healthcare that Americans actually agree on. In our Common Ground project with KFF Health News, we're looking at issues with bipartisan backing. Blake Farmer at WPLN in Nashville reports on one thing that is uniting people - their collective disdain for the healthcare companies known as pharmacy benefit managers.
BLAKE FARMER, BYLINE: Pharmacy benefit managers, known as PBMs, handle the part of health insurance related to the cost of prescription meds. They were promoted as a way to keep drug prices in check, but the largest are now owned by giant conglomerates that also own insurance companies and pharmacies. All this consolidation has turned them into a punching bag for all the frustration patients have with the healthcare system, like high prescription prices. CVS is one of the big companies that also owns a PBM. It's taking heat in Tennessee.
AMYE JOSEPH: We hate CVS. I'm going to be straight up. You can't talk to a pharmacist. They're overstressed. And prices just keep going up.
FARMER: Amye Joseph is 62 and lives in the mountainous eastern corner of Tennessee with her husband.
A JOSEPH: You're going to find this interesting. We have a two-party household. I'm a Republican (laughter). My husband's a Democrat.
FARMER: He's equally frustrated. They have a list of gripes that could fill the famously long CVS receipt. For example, Charlie Joseph discovered his blood pressure medication was actually cheaper when they didn't use insurance.
CHARLIE JOSEPH: You know, the whole healthcare thing is just frustrating on a good day.
FARMER: PBM officials say their industry has been unfairly maligned and that they're the only link in the drug supply chain trying to lower drug costs. Dave Marin, president and CEO of the Pharmaceutical Care Management Association, addressed Congress in February.
(SOUNDBITE OF ARCHIVED RECORDING)
DAVE MARIN: Yes, drug prices are still too high. Without PBMs, they would be much, much higher.
FARMER: But state lawmakers aren't buying it. Tennessee is one of two states that have now made it illegal for a company to own both a PBM and retail pharmacies. CVS fought the proposals with a multimillion-dollar TV ad campaign.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED COMMENTATOR: A hundred thirty-four CVS pharmacies across Tennessee shut down, making healthcare less accessible for families like yours.
FARMER: Those ads aired just before the vote this spring. Nevertheless, Tennessee lawmakers moved forward. Republican State Senator Rusty Crowe told his colleagues before the vote that they should consider the fierce resistance a sign that they were onto something.
(SOUNDBITE OF ARCHIVED RECORDING)
RUSTY CROWE: I learned when I was in the Vietnam War, when you start taking on flack, you know you're over the damn target pretty quick.
FARMER: Business-friendly Republicans voted alongside Democrats who favor more regulation. State Representative Antonio Parkinson, a Democrat from Memphis, says he feels like he voted in favor of lower drug prices and ma-and-pa pharmacies.
ANTONIO PARKINSON: If there's a benefit to my people, I'm supporting it.
FARMER: The most vocal critics calling for regulation of PBMs are independently owned pharmacies and their trade groups. In Tennessee, State Senator Bobby Harshbarger, who sponsored the pharmacy ownership ban, is also a small-town pharmacist. His mother is a pharmacist, too, and a member of the U.S. Congress, who's proposed a similar ban on PBMs owning pharmacies at the federal level. That bill has bipartisan sponsors and has created unlikely bedfellows of Senators Elizabeth Warren and Josh Hawley.
Antonio Ciaccia is CEO of 46brooklyn Research, a nonprofit think tank that tracks drug pricing. He says this legislative push reflects a feeling - even in the GOP - that the market for prescription drugs is being gamed.
ANTONIO CIACCIA: Republicans are looking at this issue, saying, we know what competition is supposed to do, and it isn't happening. This is not a free market. This is a free-for-all.
FARMER: In a statement, CVS told NPR the new state laws will do the opposite of what they're intended to and drive up prices. It's unclear if these bans on PBMs owning pharmacies will hold up in court, or if they do, whether CVS will follow through on closing all of its pharmacies. Either way, PBMs aren't finding many friends in politics at the moment.
For NPR News, I'm Blake Farmer in Nashville.
CHANG: This story was produced in partnership with KFF Health News. Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.