Representative Marta Bertoglio (HD75): Montana Pharmacy Protection Act

In this legislative session, I introduced House Bill 740 to help Montana’s pharmacies stand up to pharmacy benefit managers (PBMs). Decades ago, these industry giants started out filling a legitimate need in the processing and negotiating of prescription drug insurance benefits. However, they quickly grew and consolidated into some of the largest corporations in the United States, and now, just a few PMBs control virtually the entire drug benefits market.

In 2023, the top three PBMs made a collective $456.3 billion—or 20% of the national healthcare expenditure. One way they have accomplished these astonishing profits is by underpaying pharmacies (often well below the pharmacies’ costs for the medications), overcharging employers and patients, and pocketing the difference. PBMs have also opened their own mail-order and specialty pharmacies and use opaque strategies to hide the fact that they often dramatically overpay their own pharmacies.

HB 740 aims to give Montana’s pharmacies a fighting chance to survive the PBMs’ aggressive and anti-competitive efforts to drive them out of business.

PBMs insist that they drive costs down for patients and employers and that HB 740 (or any attempt to rein in their bad behavior) will cause catastrophic increases in premiums and prescription costs, ignoring the fact that they control those premiums and costs and that their own profits constitute an enormous part of those premiums and costs.

For a long time, this has been a David-and-Goliath battle, with pharmacies being helpless against the mega-corporations with their limitless budgets and lobbying potential. Indeed, pharmacies are going out of business at an alarming pace. However, there is now widespread recognition that PBMs are the problem, with the FTC, the US House Committee on Oversight and Accountability, many state legislatures, and at least 39 State Attorneys General all concluding that PBMs are driving up the cost of prescription drugs in this country, dramatically increasing their own profits on the backs of pharmacies, employees, and patients. Enough is enough. Pharmacies play a vital role in meeting the healthcare needs of our communities. The pharmacists know their customers by name and are familiar with the health challenges they face. Many of these business owners contribute significantly to the well-being of our small communities.

They are seeking a fair and level playing field. I continue to stand for HB 740, Montana’s pharmacies, hardworking businesses and workers, and patients.

I am always available - contact me at marta.bertoglio@legmt.gov.