LIVE: US Reps. Auchincloss, Harshbarger Speak on 'Pharmacy Benefit Manager Price Gouging Abuses'

And then we're going to have some pharmacist testimonials. Hey Ralph. Appreciate you joining on this. We need 25 and 25. These and ours on this bill. That is the goal for us. I don't know why anybody would sign. We're going to go in order. Honestly, it's a little bit on my side too. We're halfway there. This is it. Two minutes. He's the last one to go, so I probably will not wait for him. I will wait for her. Okay, sounds good. I'm James. Nice to meet you. Hey, I'm going to talk to Mike. I'm going to talk to Mike. You have to be mean. Hey, nice. Good afternoon. I'd like to thank the independent pharmacists, patient advocates, and members of Congress for being here today to bring attention to the price-gouging abuses of pharmacy benefit managers, or PBMs. I'd also like to thank Congresswoman Harshbarger, a pharmacist, with whom I introduced the Pharmacists Fight Back Act, bipartisan legislation to crack down on the most nefarious price-gouging abuses by pharmacy benefit managers that drive up prescription drug costs. PBMs claim to negotiate on behalf of employers and patients to lower drug costs, and that sounds very noble. That is far from the truth. In reality, PBMs are the middlemen of the drug-pricing supply chain, owned by health insurance companies and working to increase their own profits. The Federal Trade Commission's July investigation exposed the corporate greed of these PBMs. According to the FTC, these PBMs have influenced what prescription drugs are available to patients and at what they cost. Three PBMs, CVS Caremark, Cigna Express Scripps, and UnitedHealth Group's OptumRx, own 80% of the market share. They've taken money directly out of the pockets of seniors, taxpayers, and pharmacists by inflating the price of medications for their own benefit, capturing $300 billion from the U.S. healthcare system. The FTC investigation showed the plain facts. PBMs mark up the cost of drugs by thousands of percent while raking in millions of profit. Take CVS Caremark, for example. At the July House Oversight Committee hearing, I asked its president why he was charging $6,229 for a $16 multiple sclerosis drug. He had no real answer. Now, this multiple sclerosis drug is $17, and CVS Caremark has upped its price to $7,636. The greed does not end there. $5,052 for a $39 leukemia drug. $5,893 for a $91 drug for prostate cancer. PBMs also steer patients to their affiliated pharmacies, paying their own mail-order pharmacies as much as 200 times more for cancer drugs than competing non-owned pharmacies. This brought them over $1 billion in revenue off the backs of patients and independent pharmacists. The consequence is that last year, nearly one independent pharmacy closed every day in the United States. The same is expected for this year. This is because PBMs are forcing independent pharmacies to lose money by filling prescriptions through their steering practices. Over the last few weeks, I've received thousands of messages from pharmacists and patients all around the country. People who are frustrated that they can't afford their medications because they cost thousands of dollars, even with insurance. Pharmacists who are frustrated because they can't serve their patients. Yesterday, I met with Bill and Sharon Schmidknecht, the parents of Cole Schmidknecht, who lost his life after OptumRx increased the price of his daily asthma medication to the point where he was forced to choose between his medication and his rent. Bill and Sharon have become staunch and courageous advocates of PBM reform, and I am grateful they have chosen to tell their story so that no other patient or parent has to experience this pain. I would like to finally recognize the fortitude of the pharmacists standing beside me. They continue to serve their patients even when they cannot afford to. In some parts of the United States, pharmacists are their community's primary healthcare provider. I'm here today with these independent pharmacists to tell PBMs, we see you, we know what we're doing, and we're here to fight. Pharmacists fight back, we'll stop these markups, patient steering, and patient exploitation in their tracks, in federal healthcare plans, and impose criminal violations for such behavior. No more exploiting the sick, no more drugs being priced thousands of percent above their acquisition costs, and no more steering to PBM-affiliated pharmacies. I've heard from several pharmacists around the country that the Pharmacists Fight Back Act gives them hope and is the reason they will keep from shutting their doors. To these pharmacists, we will not let these PBMs hide in the dark any longer. Call your members of Congress and tell them to sponsor the Pharmacists Fight Back Act. Pharmacists are not backing down, and neither are we. Thank you, and I now want to turn this over to my colleague and co-lead of this important legislation, Representative Harshbarger of Tennessee, who is herself a 30-year pharmacist. I want to thank Jake for asking me to help co-sponsor this legislation. You know, you cannot fix a problem if you don't understand it. And, you know, I've been a pharmacist for 37 years. I've done everything you can do in pharmacy. I still have a pharmacy, retail pharmacy, compounding, sterile, non-sterile, home health, hospice, because we are an invaluable part of the health care system. You know, when I came to Congress, you just have to understand what it meant. I went from the most trusted profession to the least trusted profession to come to Congress to fight for something I've been advocating for for the last 25 years. And, as I said when I started, you cannot fix a problem if you don't understand it. And, just like these independent pharmacists behind me, they understand, and I totally understand the pressures that they go under every day just to conduct business. You know, I understand the struggles that the community pharmacists face with reimbursements, with clawbacks, the DIR fees, the prior approval, the cost of drugs, the reimbursement. And pharmacy benefit managers and the outsized domineering roles they play in our drug coverage, sending people, steering, like Jake said, sending those patients to their own pharmacies. Why would the FTC not have said that that shouldn't have happened years ago? And that's the question that, sitting on E&C, that's the one thing that we've done this past year. It's taken over a year or even two to get them to look and investigate the pharmacy benefit managers and the shadowy practices and the shell games that they play with the pharmacists, with the patients, with the rebate programs. You know, they do maneuver into shadows and they put the financial screws to independent community pharmacies and they often raise drug price and drug costs to patients by steering those prescription drug coverage to whatever pads their bottom line. You know, at the end of the day, you've got to remember, PBMs, they don't treat a single patient, they don't cure a single disease, and they do not insure a single American. That is the bottom line. And, like I said, just a couple of months back, we got the interim report, the FTC report that Representative Auchincloss was talking about. And it is detrimental to the PBM industry. You know, it shows the self-dealing, distorting competition, essentially printing their own money, and now it's well documented that there's certain medications that get marked up by thousands of dollars. And they flow toward those pharmacies that are owned by the same parent company as the PBM who sets the prices. So, it's past time to do something about these entities. That's why this pharmacist back is so important to build on many other bipartisan PBM bills and legislation. We passed the Lower Cost, More Transparency Act. There's a lot of different PBM legislation. There's still a lot of other things we're doing. We've included oversight. We've included ways and means. Any committee who wants to look at the pharmacy benefit manager practices, we've included them. Comprehensive PBM reform is an absolute necessary part of lowering drug costs for patients, employers, and government programs. And it levels the playing field for independent community pharmacists. This bill will put in place much needed reforms in federal programs to stop the gouging of independent pharmacies and make life-saving drugs more affordable for patients and implement solutions that will yield savings to the taxpayers. So, I want to thank you, Jake. I call these younger than me representatives by their first name. It's not a sign of disrespect. I just like to be on that level. I appreciate him for leading the bill and the many great pharmacists behind me that came out to support this. I want you to know that we've only begun. That's just the interim report. When we get the conclusive report, it's going to be something they can't run and hide from. I'm happy to introduce the next speaker, Representative Nikki Budinsky. We've got the parents of Bill and Sharon. Oh, okay. Wait a minute. We've got the parents. Come up here. Good morning or good afternoon. I'm Shannon Schmidtnick. This is my husband, Bill Schmidtnick. We come to you just as not pharmacists, not doctors, not politicians. We are grieving parents. Our son Cole Sorry. Our son Cole passed away January 21st of this year. Cole went to a pharmacy on January 10th to pick up a prescription that he had been on for years. Had he gone in December, that prescription would have cost him roughly $66. When he went on January 10th, he was given a price tag of over $500 for that prescription. He had asthma, a completely preventable, manageable, lifelong condition. He opted to pay his rent instead of pick up his medication on January 10th. Five days later, we received text messages and a call that Cole was having an asthma attack that got severe. On the way to the emergency room on January 15th, Cole's asthma attack turned into cardiac arrest. On January 15th, Cole ended up in the ICU and on a ventilator. As obviously we rushed to the ICU in Appleton, Wisconsin. We spent six days with our son in ICU. He passed away on January 21st 2024 over a prescription that he couldn't afford. We are so thankful to all of you, everyone standing here for PBM reform efforts and we will do everything we can to continue to support these efforts. Our son's life didn't have a price tag and we are so, so heartbroken that this is what caused his death. You know, as Shannon just said, and I'm going to be short here, we didn't know what a PBM was before all of this. What we've learned in the last six to nine months over everything is there is a need for change, there's greed, there's manipulation, there's non-transparency going on. Something you pay $66 for with no explanation is now $538.16. Let that resonate. I mean, like, that just doesn't make sense. And then on top of it, it was a medical thing needed for my son who he'd been on for 10, 12 years. Every day he took this and a decision was made you know, I mean, let's just say that I don't know what to say. Big PBM change needs to have. Pharmacy benefit managers have been overstepping and getting into the wrong areas and they're getting greedy and more and more non-transparent. Their tactics, greed, all need to stop before someone else dies and that's all there is to it. And I do want to just simply say thank you to everybody who's supporting this and we will be along the ride to make sure that every bill, the best we can do, every piece of legislation can happen. And we're not even political so we're still going to support it all. Thank you. First I want to say just to express my condolences on Cole's death and part of the big point of why we're here today is to prevent that kind of tragic loss from happening to any other family in this country. My name is Nikki Budzinski. I'm honored to represent working families in Central and Southern Illinois in Congress. When I was elected, voters tasked me with coming to Washington to help bring down the everyday costs that are holding up too many working families back. And for many Americans, these costs include thousands of dollars spent per month on life-saving prescription drugs like insulin or heart medication or asthma relief. This sky-high spending is due in part to greedy pharmaceutical benefit managers, PBMs, which for too long have taken advantage of hardworking Americans jacking up drug prices to line their own pockets. I'm proud to champion the bipartisan pharmacists fight back act to take on PBMs and to crack down on the predatory practices that harm our seniors, squeeze out community pharmacies, and rip off American taxpayers. And I'm grateful to have one of my constituents, Lauren Young, here today to share her first-hand experience with how PBMs have harmed patients and community pharmacies across Central Illinois. Lauren's family owns Coley's Corner Drugs in Decatur and Dale's Southlake Pharmacy in Forsyth. Some of the last surviving community pharmacies in the areas as PBMs have pushed the others out of business. Losing community pharmacies isn't only bad for Main Street, it's harmful for working families, Americans who rely on access to their local pharmacies to fill their prescriptions. No one should have to choose between putting food on their table or, in Cole's case, paying their rent or getting the medication that they need to survive. But that is the reality for countless folks in Central and Southern Illinois and across this country. Lowering drug costs is critical to tackling the ongoing cost of living crisis, and I'm proud to stand here today with a bipartisan group of my colleagues to support legislation that will provide transparency and accountability. We need to do just that. Thank you so much, and I'm going to now introduce my colleague, Congressman Norman. Missed my name. I just want to thank the independent pharmacies and Diana and Jake and Nikki for taking part in this. I tell you, and I'm from South Carolina, I represent the 5th District, I've been here since 17. Bipartisanship is not something that exists up here. This one bill demonstrates, and we need to have, Jake and I were talking, get 25 Republicans and 25 Democrats. No, we've got to have how anybody could not sign on to this bill means you want to keep high drug prices where they are. And Bill and Sharon, I've got a similar story. I'm a real estate developer. I didn't know what a PBM was. I had a lady call me whose husband drowned and she called me. Their daughter was on insulin and they could not afford insulin for their daughter. Now insulin is not a new drug. Insulin's been around since the 30s, 80 to 90 years. So we got involved and went to the private independent pharmacies and we got it affordable to save her life. And folks, the PBMs, and I know who's out here who's representing the PBM lobby. We're coming for you. We're going to expose you. Try looking. PBMs are supposed to be the middle manager to make sure drugs are dispensed in a proper way at a proper price. It's anything but that. Try looking at a flow chart. You tell me if you can understand it. So just like Jake said, we're going to get transparency. We're going to put this to the people of this whole country. I sent out 50 letters to private independent pharmacies to say, look, I need your help. It's going to take y'all, get in your district, and if you're not political, you will be because this is a noble cause. We cannot let this pass. You got three, you got a dominant market, three of them mainly, as Jake says, CVS, Caremark, Express Scripts, and OptumRx. They manage 95% of all prescriptions. 95%. Our bill will stop that control and our bill will put the transparency back into a group that's making billions of dollars. Not millions, but billions of dollars. Hundreds of millions of dollars in overcharges via spreading pricing in Medicaid, managed care, part one. A large PBM in part D increased generic drug prices, get this, generic drug prices by 51% for seniors at the counter despite these generics deflating over 8% during the same period. Bottom line folks, as Diana said, PBMs don't prescribe or dispense drugs. PBMs don't pay employees. PBMs don't pay the rent on your buildings as you operate. PBMs are basically a middleman that's fleecing the American public. And what we're going to do, we're not quitting, we're going to have more hearings and get experts like Diana who is a compounding in her store for over 30 years and get others who can get these PBM managers in, let them testify and let them try to explain what's happening. So I just want to thank all of my colleagues. This is going to be a fun fight. This is what we were sent to Washington D.C. to do. Good afternoon. I'm Sanford Bishop. I'm from the 2nd District of Georgia, which is middle and southwest Georgia. And I'm honored to join Representative Austin Closs, Representative Hartsberger and others in support of the Pharmacists Fight Back Act. I also want to welcome the participants here from Georgia, especially Nikki Bryant, the owner of the Adams Family Pharmacy in Preston, Georgia and Vic Johnson. This bipartisan legislation is long overdue. Last July's interim report by the FTC only confirms facts that we've known for a long time, namely that pharmacy benefit managers are fleecing independent pharmacists and consumers to the tune of billions of dollars every year. The largest PBMs today exercise significant power over what drugs are available and at what price and which pharmacies that patients can use to access their prescribed medications. They do so without any transparency, without any accountability to the American public. They act not in the best interest of their patients. They act instead in the best interest of their profits. It is only right then that Congress steps in with common sense legislation like the Pharmacies Fight Back Act to right these wrongs and rein in PBM abuses. I have visited independent pharmacies across my district over the last several years and I've seen the spreadsheets and I've seen the abuses that they have suffered. We need all of your efforts here today to knock on the doors of your members of Congress and to urge them to co-sponsor HR 9096. We also need your help to urge the committees of jurisdiction to hold hearings on the issues and to send this bill to the full United States House of Representatives for its consideration in an expedient manner. PBM reform is an issue that cannot wait. I promise you that I will do everything in my power along with my colleagues to help pharmacists particularly independent pharmacists and their customers to fight back. Thank you for joining this fight and God bless us in this effort. Once again I appreciate the leadership of my colleagues on this effort and we're going to now hear pharmacist testimonies from around the country beginning with Brandi Chain the president of Davis City Pharmacy in Texas. Welcome. Hi my name is Brandi Chain. I own one of the oldest pharmacies in the state of Texas. Our doors opened in 1892. In that time we've cared for hundreds of thousands of patients. Our country is facing an epidemic of pharmacy closures. My pharmacy is at risk of closing because of PBM practices like steering my own patients to a PBM owned pharmacy. As a military spouse my mom utilizes Tricare for Life for her prescription benefits. I cannot fill her prescriptions at my own store due to the lack of a sustainable contract with Tricare's PBM and she's forced to get her medications at a chain pharmacy. I've seen first hand the lack of patient access for a loved one. Millions of patients just like my mom will be impacted by the continued closure of independent pharmacies without the passage of HR 9096. The Pharmacists Fight Back Act would allow independent pharmacies to receive a fair reimbursement rate for the services provided to patients. Have our military service members and their families not given enough to our country? Is it too much to ask that community pharmacies receive necessary reimbursement for our vital services provided? The Pharmacists Fight Back Act would not only make this a reality, it would also allow me to keep my doors open. Patient access begins and ends with open pharmacies. I urge everyone watching to contact your legislators and ask them to co-sponsor and support the Pharmacists Fight Back Act. Thank you to representatives Auchincloss and Harshbarger and the other legislators who have co-sponsored this bill for your continued support of community pharmacies and patients like mine. Thank you. Loretta Boesing, founder of Unite for Safe Medications based in Missouri. Loretta, welcome. Thank you. My name is Loretta Boesing and I am the executive director of Unite for Safe Medications. I founded Unite for Safe Medications after my child's life was risked by a malware pharmacy that we were forced to use. My son is a courageous transplant survivor who received a life-saving organ transplant from a three-year-old little girl. Prior he was a healthy two-year-old until he got the flu and our lives drastically changed. Now, forever, his survival will rely on medications every 12 hours. One day we were forced away from our trusted hospital pharmacy and forced to use CBS Specialty Pharmacy and the so-called benefits of a malware pharmacy were nothing more than a claim to extract profits from the sickest of patients like my son. PBM's malware pharmacies, they operate with minimal oversight, leading to dangerous delays, interruptions in treatment, and damaged medications, and most often there's little to no accountability. Then I found out that PBM, such as CBS Caremark, not only oversee their competitors' reimbursements but also their own. I found out CBS Caremark was reimbursing its own malware pharmacy many more times than my local pharmacy, and it was all under the disguise of a lower copay. And sadly, my family's story is not unique. I started a petition that now has 220,000 supporters to stop the forcing of malware pharmacy. The heartbreaking stories that I've heard, they're never-ending. Veterans suffering from malware pharmacy delays without their medications needed to treat the mental and the physical wounds obtained from fighting for our nation. Adult and pediatric cancer patients facing delays and interruptions in treatment that worsen their conditions. As the same as they sit in the local pharmacies and the hospital pharmacies, but the PBMs, they won't cover them, they mandate to their own mail order. These stories are a testament to the human cost of this flawed system. Today I stand before you firmly in support of H.R. 9096. This bill addresses the injustices faced by patients across America. It's a call to action to end the harmful practices of mail order pharmacies and their PBMs, combat drug price gouging, and address the crisis of pharmacy closures. And it will also protect patients like my son. Together, let's pass H.R. 9096 and protect the lives and well-being of every patient and community in this country. Thank you so much. Now from Georgia, Vic Johnson, owner of Living Well Pharmacy. Distinguished members of Congress and staff, fellow pharmacists, news media, social media, and all Americans, good afternoon. I'm Vic Johnson. I'm a pharmacist, owner at Living Well Pharmacy in Augusta, Georgia. And it is an honor to be standing here at the capital of the United States. Many pharmacists have had to close in our area. In the mid-80s, we had 24 independent pharmacies in the Augusta, Georgia area. We are now down to four. This has happened because of the PBM practices. The reimbursement rates have gone terribly, terribly south as they fill their own pockets with profits. But there are even more groups who are impacted by practices of pharmacy benefit managers. And it becomes my focus here today. The elderly, the disabled, children, and the poor of this great country have been negatively impacted by pharmacy benefit managers. Medicare that represents seniors and disabled persons, Medicaid, children and the poor, and even tax paying citizens have been impacted by the billions of dollars that are paid to pharmacy benefit managers and their stockholders with very little, if any, positive impact on their health. In fact, most of the groups mentioned here have had their pharmacy choices limited to either a particular drug chain or mail order. Pharmacists are the most accessible healthcare professionals. And yet this access is being taken away by pharmacy benefit managers. Please, let's stand up for our seniors, the disabled, the children and the poor, and the right to choose your own pharmacist. Call your congressman today. Support House Bill 9096, the Pharmacists Fight Back Act. Call today. Thank you. The Executive Director of the Kentucky Pharmacists Association, Ben Mudd. Ben, welcome. Good afternoon. And thank you for being here. My name is Dr. Ben Mudd. I'm a pharmacist and the Executive Director of the Kentucky Pharmacists Association. I'm speaking today on behalf of pharmacists across the great Commonwealth of Kentucky to express our gratitude to Congressman Auchincloss and Congresswoman Harshbarger for introducing H.R. 9096, the Pharmacists Fight Back Act. More and more, Americans are arriving at their local pharmacies only to find the doors shuttered. Independent pharmacies are struggling to remain in business, and even chain drug stores in Kentucky are being forced to reduce hours and cut staffing. This has led to burnout within our profession and a decline in the overall quality of patient care. As a pharmacist, I know firsthand the critical role my colleagues play in improving the health of our communities. However, with enrollment in our colleges of pharmacy declining and pharmacies closing at an alarming rate, I fear we are facing a health care crisis. Now is the time for pharmacists to fight back. To fight back against the pharmacy middlemen that have harmed our profession. To fight back against the narrative that these PBMs are saving health care dollars. And to fight back against these companies that continue to threaten patient access to local pharmacy services. In Kentucky, we've already seen the positive impact that PBM reform can have. We've seen it in our Medicaid program, through Senate Bill 50 that was passed in 2020, and in our commercial marketplace in Senate Bill 188 that was passed this year. But these, this PBM needs to, PBM reform needs to be expanded upon in our federal programs. HR 9096 is essential to ensuring fair and transparent reimbursement practices for pharmacies across the country. It will protect patient choice, increase access to pharmacy services, and strengthen our overall health care system. I want to commend the efforts of our Kentucky congressional leaders, especially my congressman, Congressman James Comer, for co-sponsoring this bill, and we urge swift passage of this critical legislation. Thank you all. We'll conclude by hearing from the owner of the pharmacist the Adams Family Pharmacy, excuse me, from Georgia, Nikki Bryant. Welcome, Nikki. I was reflecting on these congressmen and women who are spearheading this reform, and I cannot tell you how grateful I am to them. Because this is something that you do because it's the right thing. And it gives me a great sense of pride and a disresolve that we have people in Washington that are advocating for us because it's the right thing to do. And I really commend you and thank you for that. There's a girl who lives in a rural southwest Georgia town eight miles west of President Jimmy Carter. Ten years ago, she became a third-generation small business owner when she converted two parking spots in her father's grocery store and opened a pharmacy in that town for the first time in 60 years. She quickly realized that her patients needed access to medical care as well, so she opened a doctor's office, and now it's a federal rural health clinic in her town. Thirty miles south in Cuthbert, Georgia, the only pharmacy open there was a CVS, and patients were not being cared for properly, so why not? She opened a second pharmacy there. Reimbursements have continued to decline, and she had to find a way to keep her pharmacies open. So she started to bake. She bakes cakes, she bakes cookies, she bakes homemade biscuits, she pulls espresso shots, she dips ice cream, she makes milkshakes, all to keep her pharmacies open. Now she and her family have the only pharmacy, grocery store, and doctor's office in Webster County. And as of August 1st, when CVS closed in Cuthbert, she now has the only pharmacy in that town as well. Between both of her pharmacies, she now has patients in 12 southwest Georgia counties through delivery to the most vulnerable, remote parts of our state. If anyone can guess, I'm that girl. It's me. And looking from the outside in, my friends would seem like I'm living the American Dream. I heard that on Prime TV last week. Living the American Dream. And it would seem that I would be. But I can tell you, this is a literal nightmare for me. To carry the burden financially, the stress, all of the care for so many people without the resources to do that. Because PBMs are allowed to set my reimbursement rates. I made more money on a regular cup of drip coffee than on 40% of the prescriptions I filled in 2024. 40%. All the while, CEOs of PBMs are making $40 per minute, 24 hours a day. Even while they sleep. Over 200, 2200 pharmacies in the U.S. have closed this year. That includes independent pharmacies, grocery store pharmacies, and chain pharmacies. And they will continue to grow unless this legislation is not passed and quickly. There is a rate of 9 independent pharmacies closing every day in the United States. My patients deserve better. They deserve more. And I will continue to fight for them and to the access to care in rural America. Because the people standing here know that rural America is the heartbeat of this country. You know, Georgia, if you don't live in Atlanta, you live in a rural community. So, Congressman Bishop knows very well how rural Georgia is the heartbeat of our state. I just hope and pray that once we get this all taken care of that mail order won't be the only option for any of us to fill a prescription. What would we do if that were the case? I thank you. I commend you. I can't tell you how grateful I am for everything that you're doing. Again, I'm grateful for the support and leadership of my colleagues and most of all for the time, the effort, the passion, the expertise that the pharmacists are bringing to this cause. I know that it's not easy to take time off from the small business and to come up here to Washington and have someone else tend shop. So it shows the level of determination and it shows the unity that we're going to bring to this effort. We're all fighting back together. Happy to take any questions alongside my colleague Congresswoman Harshbarger if folks have any. Yeah, I would say right off the bat, this is the most muscular federal PBM reform legislation yet introduced. And it's bipartisan and it goes I think directly at the most egregious abuses by PBMs. It prevents them from excluding from their network community pharmacists. It prevents them from engaging in steering. It prevents them from the clawback fees that are so oftentimes the catalyst for bankruptcy. And it also really creates a transparent market with a fair dispensing fee by making NADAC reporting compulsory and making it comprehensive. Plus you have transparency on the rebate program with this bill. And the simpler legislation is, the easier it is to talk to other members. And it's my job, just like you know and you know, our job is to be able to tell other members on a 6th grade level what we've got in this legislation. Because you want to make it simple addition or subtraction, not a calculus problem. The PBMs make it a calculus problem. To where you don't understand. And all they say is, let me have my doctor and my medicine, la la la, about all these other things. The prior approval or you know, anything else. But you talked about the legislation the lower cost and more transparency act. We think we're going to have another slate of bills coming through that will have PBM legislation in it. That we will pass out of the House. I know it's coming out of Energy and Commerce. We'll have those I think next week Peter or when we come back in November. We'll be passing those. And the Senate is engaged. Don't think it's just the House that's engaged on both sides. It's the Senate. They come to the doctor's caucus which I'm also a member of. And when those, you have Senator Bernie Sanders, you have Roger Marshall, you'll have Senator Cassidy. All those gentlemen understand we have to do something. So we're going to work in a bipartisan effort if every member and this is how you can you all wanted us to get 25 and 25. Every representative in the House has an independent pharmacy in their district. Probably in every county. Unless it's Georgia. Southwest Georgia. And I'm telling you if they don't sign on it's their loss. Because this is important. I didn't come up here on the Hill to waste my time. That's why this has been pushed and I have been hard and heavy when I've come up here for the last 25 years to talk to my congressmen, my senators about my profession and the over burdensome crushing regulation that prevents me from doing my job when I'm the closest thing to a healthcare provider that most patients have. We have pharmacy deserts. We have nobody to care for them. You don't have to have an appointment to come and see us, do you? Most people are five minutes from us and we triage them and send them in the best way. Listen, when they try to take that away from us, just like some of the stories you heard, there's going to be lives lost because mail order doesn't always get there on time. And prior approval are not going to always be approved in time. So yes I do because I'm not going to stop pushing this legislation. So something's going to pass and the FTC has my phone number and when Chair Cohen calls me I'm like, yes ma'am, how can I help you? And that's what we're doing on both sides, on the House and the Senate and it's bipartisan, right? That's right. This is not a partisan issue. It's not a local issue. It's an issue all across the country. You've heard here today that this affects people in every area of this country. It's not a Democrat problem. It's not a Republican problem. It's an American problem and we are working together to make sure we have an American solution to it. It will pass. This is something that is felt by every single member of the House and the Senate and by God, we're going to get it done. It's my kind of man. Yes ma'am. ... Yeah, I think we're going to I'll speak for myself, certainly going to push in December there's going to be negotiations around telehealth and around community health center funding and I think it's imperative that PBM reform be included in that and that it not just be sort of a lowest common denominator transparency piece of legislation. It needs to be muscular with kind of the pharmacist fight back tenets included in it. Yeah, exactly. And, you know, like I say, we've already passed a lot of PBM legislation. It's going to be a lot of work. We're going to work our Senate colleagues, too, to say, listen, we need to do something now. We have all those closures. Why don't you say nine a day, one a day, nine a day? It doesn't matter. They're closing because they have no hope. If you can't feed your family, you're going to go on to greener pastures. You're going to go to work for CVS or the hospital system or some other entities. So we don't want that. We want to be there to take... I've done this for 37 years at a local level and that's why I brought the fight to the federal level. And, yes, I think we'll get some things passed. We've got to work with the Senate in order to do that. Where there's a will, there is a way. If there's a will in Congress and the House and the Senate to get it done, the rules allow for it to be done. But that will has to be developed by the grassroots of the people here. You've got to contact your members and those members have to contact our leadership to make sure that we find one of the ways, and there are numerous ways that this bill can be brought and can be passed within this Congress. But there has to be a will to get it done. I believe there is a will and if we do what we need to do in terms of informing our colleagues and having you to put fire up under each and every member of the House and the Senate, it'll happen. I just want to tell you one other thing. I'm a capitalist at heart and we're not trying to kill the PBMs. I just want to mortally wound them until they straighten up. That's all I'm saying. If you can bring transparency to this, we can all get along. But it's when you don't tell us what you're doing and you hide the billions and those patients don't get to rebate, the pharmacies are not compensated fairly and I would even go as far to say the physician reimbursement, we're working on that. If you don't think we have a one-payer system in this country, think again. And I won't go into that right now. All you have to do is look at United. Thank you for your attention and time on this critical issue and as you can see, there is durable and bipartisan support and grassroots support for pharmacists to fight back. Thank you. Thank you so much. Thank you. Thank you so much. Thank you. I thank you. It's so fantastic. You woke me up to the issue. Thank you. Have your same problem. We both hope... we both hope that that'll succeed.