When I opened Westside Pharmacy in 2014, it was more than a business decision. It was a leap of faith. I wanted to build something that reflected the spirit of Bend, a welcoming local place where we know your name, ask about your vacation, pet your dog, and treat you like family. A place where healthcare isn’t just transactional but rooted in trust, kindness, and connection.
For over a decade, my team and I have poured everything into that vision. And yet, despite our commitment and the support of our community, we are now at a breaking point. The greatest threat to our survival isn’t competition from big box stores or economic downturns. It’s the unchecked power and predatory business practices of Pharmacy Benefit Managers, or PBMs.
PBMs are the corporate middlemen that stand between patients, pharmacies, drug manufacturers, and the health plans that pay for care. Most people have never heard of them, and yet they have an extraordinary amount of control over the entire prescription drug system. They decide which medications are covered, how much patients pay, and how much pharmacies get reimbursed.
PBMs use their control to make billions in profits at the expense of everyone else, especially patients and small community pharmacies.
At Westside Pharmacy last year, we filled nearly 23,000 prescriptions at reimbursement rates that were less than the cost of the medications themselves. We filled another 40,000 at rates that didn’t even cover our basic operating expenses. PBMs offer us contracts with dispensing rates that are sometimes zero dollars or just a few cents, when it costs us over fifteen dollars to safely fill and dispense a single prescription. They tell us we have to take these contracts or lose all the business they control which would sink most pharmacies.
This isn’t sustainable. And we are far from alone. Since 2008, more than 200 pharmacies have closed in Oregon, many of them in rural or underserved communities where they were the only option for miles. Oregon now ranks 49th in the country for pharmacy access. That is unbelievable.
We have the means to change the story, and we need community support to achieve it. House Bill 3212, now before the Oregon Legislature, offers a critical chance to bring transparency and fairness to this broken system. It will ban anti-competitive contracting practices, protect patient choice, and prevent PBMs from steering patients away from their local pharmacy to one the PBM owns. With amendments proposed by the Oregon State Pharmacy Association, PBMs would be required to pay us at the same rate that they pay the pharmacies owned by their conglomerate.
I often speak with patients who are shocked to learn how much control PBMs have. I often speak with patients who are shocked to learn how much control PBMs have. The truth is, PBMs are skimming massive profits off the top, charging health plans up to 80 percent more than they pay us for generics, keeping most manufacturer rebates for themselves, and funneling business to their own affiliated pharmacies while shutting others out.
The situation has become so dire that the Federal Trade Commission is now investigating the nation’s largest PBMs, citing evidence that they are driving up costs and harming independent pharmacies through spread pricing and other abusive tactics. But Congress has yet to act. That’s why Oregon must do so.
Oregon’s pharmacy access crisis is not theoretical. It is happening now. At Westside Pharmacy, we are holding on, but every month it gets harder. HB 3212 is our chance to change course.
Pharmacies like mine are more than storefronts. We are healthcare providers, small business employers and community hubs. We believe in being good to people. We show up every day because we care.
It is time for the Oregon Legislature to show up for us.
Support HB 3212. Save Oregon’s pharmacies. Protect our communities.
Kristen Erickson is the owner of Westside Pharmacy in Bend. Learn more about how to help pass HB 3212 and contact your legislators at oregonpharmacy.org/page/PBMadvocacy#/1.
