
Part IV: Prescription drug blame game
- Medicare prescription-drugs have skyrocketed 89% in Georgia from 2013 to 2019.
- Prices for common medications in Georgia have also ballooned during that time.
- Cost transparency is lacking even from state government as key prescription-drug players blame each other.
The inability of many people in Georgia to pay for prescription drugs also hits local independent pharmacists like Chelley Williams, who opened a pharmacy in Douglas County in 2015.
A constant source of trouble was penalties Williams faced when patients skipped picking up prescriptions because they could not afford them, she said. Each time that happened, she lost out on a chunk of the reimbursements that pharmacies receive to fill prescriptions, she said. The practice caused Williams’ pharmacy to hemorrhage money, forcing her to shut down in 2019.
“It was kind of a vicious cycle,” Williams said in a recent interview. “In the end, the patient loses. They’re paying more.”

Williams traced much of her pharmacy’s financial issues to companies called pharmacy benefit managers that act as intermediaries between health plans and drugmakers to negotiate medication costs. Critics argue most pharmacy benefit managers worsen drug prices rather than help lower them. They point to a complicated system of drug discounts and how medications are ranked on certain lists that pharmacy benefit managers influence as the root of recent rising prices.
Rebates that go to pharmacy benefit managers to help lower the overall costs of prescription drugs often never made it to patients’ pockets, offering little relief for Georgia patients when medication costs crop up that their plans don’t cover, said Greg Reybold, the general counsel with the Georgia Pharmacy Association.
“When (pharmacy benefit managers) are acting at their worst, they’re able to exploit drug markets at a massive scale,” Reybold said in a recent interview. “They’ve monetized every side of it.”
For their part, many pharmacy benefit managers point the finger right back at drugmakers who they claim set the initial cost for medications too high and push more expensive brand-name drugs when cheaper alternatives exist. Many pharmacy benefit managers also accuse independent pharmacies of being profit-driven when pushing for recent regulations in Georgia that they claim limit their ability to negotiate drug prices and secure discounts from drugmakers to drive down the final cost of medications.
“Any assertion that (pharmacy benefit managers) are raising drug costs is completely false,” said Greg Lopes, a senior vice president with Pharmaceutical Care Management Association. “(Pharmacy benefit managers) are the one member of the (prescription-drug) supply and payment chain working to reduce costs.”
NEXT
Read this story for free.
Create AccountRead this story for free
By submitting your information, you agree to the Terms of Service and acknowledge our Privacy Policy.
Already a member? Login here
Food insecurity in Georgia is huge, and a Senate bill hopes to bring parties together to figure out how to fix it
A two-year effort to tackle food insecurity in Georgia may be coming to fruition. The General Assembly is now moving on SB 177, a bill to create a Food Security Advisory Council that would find ways to get more healthy food to economically disadvantaged people in underserved areas. It began in early 2021, when Sen. Harold …
Q&A: Georgia’s new ag commissioner says agriculture is more than ‘cows, sows & plows’
Tyler Harper makes no apologies for vigorously preserving and guarding Georgia’s farmland. “Agriculture at the end of the day is national security,” Georgia’s newest agriculture commissioner told State Affairs. “We’ve got to ensure that we’re protecting our food supply and providing the food, the fiber, the shelter for ourselves right here at home.” Harper became …
Q&A: New Department of Labor commissioner is taking stock and making changes, aiming for a better experience for Georgians
When Bruce Thompson says he has an open-door policy, he means it. Literally. The badge-only elevator access to his sixth-floor executive suite in downtown Atlanta is gone, removed shortly after his arrival in January as Georgia labor commissioner. “We’re treating it like any other floor now. The doors are wide open,” Thompson told State Affairs. …
COMMENTARY: Uncovering the truth: The role Freedom of Information laws play in student journalism
Editor’s note: The New Leaders Association (NLA), formerly the American Society of News Editors, created Sunshine Week 17 years ago to promote open government. NLA and the Society of Professional Journalists host the national celebration of access to public information and what it means to citizens across the country. We asked Rohan Movva, a high …