Letters: The policies of pharmacy benefit managers continue to erode community pharmacies

Chicago Tribune

08-03-2025

The Tribune Editorial Board rightly acknowledges that pharmacy benefit managers (PBMs) play a significant role in cost of medications, but it underestimates their destructive impact on patient access to care and community pharmacies ('Another layer of bureaucracy isn't the answer for beleaguered pharmacies, Gov. Pritzker,' March 3). PBMs, operating with little transparency or oversight, continue to manipulate reimbursements, imposing multitudinous fees, and steer patients to their own affiliated pharmacies, all while extracting billions in profits at the expense of patients and local pharmacies.
The consequences of unchecked PBM practices are clear in Illinois, where more than 80 pharmacies closed in 2024 alone. These closures are not just numbers; they represent real communities losing essential health care access. Pharmacy deserts — areas with limited or no access to prescriptions and pharmacist services — are expanding, disproportionately affecting rural areas and underserved urban communities. When local pharmacies close, patients face delays in obtaining medications, reduced access to pharmacist counseling and disruptions in continuity of care, particularly for those with chronic conditions.
While PBMs claim to lower costs, the reality is that they frequently retain manufacturer rebates and negotiate prices in ways that increase patient out-of-pocket expenses. The Federal Trade Commission and state investigations have extensively documented how the three largest PBMs that control nearly 80% of prescription claims — CVS Caremark, Express Scripts and OptumRx — inflate drug prices, restrict access to necessary medications and engage in anti-competitive practices that limit patient choice.
In 2022 alone, PBM-negotiated rebates totaled $236 billion — savings that should be passed on to consumers but are instead used to boost PBM profits.
Illinois pharmacists are on the front lines of patient care, ensuring medication safety, patient adherence and accessibility. Yet, PBM policies continue to erode the sustainability of community pharmacies and even affect major chains. If Illinois fails to act, pharmacy closures will accelerate, deepening health care disparities across the state.
We urge policymakers to implement meaningful PBM reforms that prioritize patient access, enforce transparency and ensure fair reimbursement for pharmacies. Gov. JB Pritzker's approach to lowering the cost of prescription drugs is spot-on.
By shining the bright light of transparency on the PBMs, we will redirect the benefits from the PBM middlemen and return them to the plan sponsors, the patients and the pharmacists who care for them. The people of Illinois deserve a pharmacy system that works for them, not one controlled by corporate middlemen prioritizing profit over care.
Without action, more communities will continue to lose access to essential health care services.
— Garth Reynolds, executive director, Illinois Pharmacists Association, Springfield
Broadway makeover
If you drive along Broadway between Montrose and Devon avenues, you'll see the types of strip malls, drive-thrus and big-box stores that are more reminiscent of the suburbs than a city.
The Broadway Land Use Framework Plan aims to change the state of Broadway and allow this portion of Chicago to be a city. A city is a place for people and businesses to live and thrive together, not for people to drive to the Starbucks shack for a costly coffee-type drink.
All of the best parts of Chicago are the parts we have allowed to continue functioning like a city. They also happen to be the parts that are the most in demand, with the highest home prices and rents. These areas are generating the most taxes for the city per acre and are lowering the tax burden for the residents elsewhere throughout Chicago.
It's time for this area to become the city again and start contributing its fair share to Chicago's housing and commercial markets. Adoption of the Broadway Land Use Framework Plan by the City Council would allow midrise, mixed-use commercial and residential buildings to go up over time and usher Broadway back into the fold as the city.
— Allison Darrahill, Chicago
A catalyst for change
Each day, social workers help millions of Americans navigate life's challenges, and their skills are needed now more than ever.
Social workers work in many areas of our society — hospitals, schools, social service agencies, libraries and hospitals, to name a few.
As a social worker at Lutheran Child and Family Services of Illinois, a child welfare agency, I witness daily the power of compassion and hope in being a catalyst for positive change in others' lives.
That's why the 2025 theme for Social Work Month, Compassion + Action, truly resonates with me.
In a world where so many are facing daily struggles in their lives, the theme speaks to the core of our profession: the need to transform compassion into tangible action and produce positive, lasting results. It calls on social workers to not only provide support but also to engage in advocacy, influence policy and work toward long-term solutions.
We need to empower social workers to continue doing the vital work of meeting people where they are and providing compassionate guidance and help to overcome adversities.
To my fellow social workers, thank you for your dedication and unwavering support of those in need. And to our community, I urge you to support policies and initiatives that strengthen social services and invest in the well-being of our children and families, not only during Social Work Month but also year-round.
Together, we can build a more compassionate world.
— Mike Bertrand, president and CEO, Lutheran Child and Family Services of Illinois, Oakbrook Terrace
Halftime show flaws
Steve Hetzel's letter ('Value of halftime show,' Feb. 15), which implies Tribune sports columnist Paul Sullivan was living with 'the privilege of being white' when he criticized Super Bowl LIX's hip-hop halftime show, is grossly unfair and misses the point entirely of Sullivan's column ('Worst Super Bowl ever?' Feb. 11).
Playing the race card is cheap. With a lifetime of sports reporting under his belt, Sullivan was employing his always-witty prose to raise the very real question as to whether the NFL had lost its way in how it presented this year's Super Bowl as America's premiere football event.
Anyone who remembers the jaw-dropping halftime extravaganzas from the 1990s can relate to Sullivan's cutting remarks. Featuring superstars such as Michael Jackson, Madonna and Gloria Estefan and produced by the likes of the Walt Disney Co. — a corporation that had its finger on the pulse of Americans of all ethnicities — the spectaculars were must-watch TV.
When the NFL hired corporate entertainment groups such as MTV and Clear Channel Entertainment to produce its shows in the 2000s, they became more technicalized and formulaic. When the organization signed rapper Jay-Z's Roc Nation in 2019, the performances narrowed further, centering around hip-hop while shunting aside rock, country, pop and other music genres that are also reflective of America's melting pot.
Perhaps Sullivan exaggerated when he wrote 'tens of millions' of viewers don't like hip-hop, but whole generations of Americans have never given it agency. Even today, gangsta and drill rappers make headlines right here in Chicago when their music explodes into rivalries and retaliatory murders.
While hip-hop has its adherents, it is indisputably a disruptive art form.
So when Sullivan, a three-time Illinois Sportswriter of the Year, asked the important question of where pro football is going when it promotes hip-hop's divisiveness over harmony and celebration in its halftime shows, I only hope the NFL is listening.