Putting Patient Care First

Transparent Pricing and Personalized Service Without Pharmacy Benefit Managers (PBMs) Interference

PBMs and Your Prescription Costs:

What You Should Know Before 2025

At Williamsburg Drug Company, we have always put patient care first. As the healthcare landscape evolves, it has become necessary to make some changes to continue providing the highest quality of care to our patients. Starting in 2025, Pharmacy Benefit Managers (PBMs) will no longer contract with our pharmacy. We understand that this may raise questions, so we’ve prepared this guide to help you understand why we’ve made this decision and how it affects you.

What Are PBMs?

Pharmacy Benefit Managers are third-party companies hired by health insurers to manage prescription drug benefits. PBMs are involved in nearly every prescription filled in the U.S., and while they claim to lower drug costs, their business practices often increase costs for patients while reducing transparency and access.

Market Control

Three PBMs—Caremark, Express Scripts, and OptumRx—control nearly 90% of all prescriptions in the U.S., giving them immense power to dictate drug prices and terms for independent pharmacies (Pharmacy Times)(pharmaphorum).

Drug Price Inflation

PBMs negotiate secretive rebate agreements with drug manufacturers, often incentivizing the use of more expensive drugs rather than affordable generics. This leads to higher drug prices, forcing nearly 30% of Americans to ration or skip medications due to cost (Federal Trade Commission)(Pharmacy Times).

Why Are We Moving Away from PBMs?

At Williamsburg Drug Company, we have felt the effects of these PBM contracts and understand that PBM contracts are unsustainable for independent pharmacies. Here’s why:

Unfair Contracts

PBMs impose take-it-or-leave-it contracts on independent pharmacies with reimbursement rates that are often lower than the cost of the drug itself. These contracts are intentionally complex, making it difficult for pharmacies to know how much they’ll be reimbursed (Drug Topics).

Self-Preference

PBMs often steer patients toward pharmacies they own, providing higher reimbursements to their own affiliated businesses, which forces smaller pharmacies out of the market(Pharmacy Times). This kind of vertical integration squeezes out independent competition while further inflating drug costs for patients (Federal Trade Commission)(Drug Topics).

Patient Impact

The practices of PBMs have led to the closure of 10% of independent pharmacies in rural areas between 2013 and 2022, worsening access to healthcare in underserved regions (pharmaphorum).

For these reasons, we have chosen not to accept PBM contracts, as they do not align with our commitment to fair pricing and quality care.

How Does This Affect Me as a Patient?

You can still fill your prescriptions at Williamsburg Drug Company. Here’s how our new approach will benefit you:

1. Transparent Pricing

By moving away from insurance contracts, we can offer straightforward cash prices without hidden fees or unexpected copays. In many cases, our cash prices will be comparable to or even lower than your current insurance copays. You will know exactly how much you are paying for your medication upfront.

2. No PBM Restrictions

Without PBM interference, we can work directly with you to provide personalized care, including more affordable alternatives like generics, and help you avoid inflated costs imposed by PBMs. This gives us more flexibility to find cost-effective solutions tailored to your needs (pharmaphorum).

3. Continued Commitment to Quality Care

Although we are no longer accepting insurance contracts, our commitment to your health and well-being remains the same. We’ll continue to provide expert guidance on medication management and overall healthcare, without the limitations imposed by PBMs.

Frequently Asked Questions

What Is a PBM?

A PBM is a middleman hired by insurance companies to manage prescription drug plans. They negotiate prices with drug manufacturers and pharmacies, but their business practices often result in higher prices for patients and lower reimbursements for pharmacies.

Why Doesn’t Williamsburg Drug Company Take My Insurance Anymore?

We’ve decided to stop accepting PBM contracts because their terms make it financially unsustainable for us to continue offering the level of personalized care you deserve. PBMs often reimburse us less than what it costs to fill prescriptions, and they also steer patients to their own affiliated pharmacies.

Can I Still Get My Prescriptions at Williamsburg Drug Company?

Yes! You can still fill your prescriptions here at a transparent and competitive cash price. In many cases, this price will be lower than what you would pay with insurance.

Will This Change Increase My Costs?

In some cases, our cash prices will be lower than what you would pay with insurance, while in others, the price may be slightly higher. We are committed to offering fair, transparent pricing and will always discuss options with you to ensure you’re getting the best value for your medications.

How Do I Find Out the Cash Price of My Medication?

You can call us, stop by the pharmacy, or use our online prescription pricing tool to get the exact cash price for your medications. We are happy to discuss all your options with you.

How Do PBMs Impact Drug Prices?

PBMs often receive rebates from drug manufacturers in exchange for keeping higher-cost brand-name drugs on their formularies, making it harder for patients to access cheaper generics. This drives up drug prices, and PBMs keep a significant portion of the rebates, resulting in higher costs for patients(Drug Topics).

Our Guests' Experiences

Kendall Leach

19:21 05 Sep 24

My favorite pharmacy hands down! If you want a pharmacy that tailers your medicine to what you need quickly, well organized and making sure you understand each medication you take, this is the pharmacy for you. They even offer free delivery. Also if you're like me and take many medications, at different times of the day they off medicines in a box. It's all your oral medicine individually packaged on a kind of ticket roll delivery system that cuts all the opening different bottles right out of the equation! Also a free service that I never knew I always needed! Thank you Ken, Taylor, Debbie, Lisa and everyone else that's helped me over the many years I didn't mention. I'm forever grateful.

Stacy Whipple

17:53 05 Jul 24

T.W. Taylor the owner and Pharmacist of the Williamsburg Drug Company has to be THE BEST Pharmacist that I have ever met! There were a few hiccups with my first order placed with them and he not only made it right, he drove almost an hour out of his way to hand deliver it himself and apologize. I was totally impressed and will definitely continue to have them fill my prescriptions. No one is perfect, it's how they handle the situation that makes it perfect.Thank you again T.W. for driving the distance.

Brenda L Gordon

23:53 01 Jun 24

Staff is very friendly and helpful.

Stephen Chamberlain

16:24 07 May 24

The Pharmacists and staff are all so professional and helpful with all our prescription needs. Additionally, we appreciate their complete inventory of health care supplies we need from time to time as ordered by our primary care physician and chiropractor. It is always a pleasure walking into their two stores and be greeted by everyone.

Christopher Heidt

15:12 07 May 24

Great and fast service. I don't live in Williamsburg, I live in Virginia Beach, but my doctor prescribed some vital medications that are only available from Williamsburg Drug Company. I couldn't be more pleased with the service, the kindness and patience of the pharmacists. Great job WDC! I will stay a loyal customer!

Cliff Gauthier

15:08 07 May 24

Williamsburg Drug Company totally bailed us out while I was caretaking for my wife with their caring and home delivery. They also have a great vaccination service. Supporting local business is important to me and Williamsburg Drug makes that an easy decision.