Reprieve for Kentucky’s independent pharmacies is saving Medicaid millions

Pharmacist Joel Thornbury said his role is far more than filling prescriptions at the NOVA Pharmacy he owns in Pikeville — he’s a readily accessible source of health services and advice in his community.

“When you call me, you get me,” said Thornbury, a third-generation pharmacist in practice for more than 30 years. “I see you on the street. I’m not some big corporation.”

And Thornbury said his job has become far more manageable, following the state’s decision in 2020 to eliminate multiple corporate middlemen that previously managed the state’s Medicaid prescription drug business — taking a big cut of the proceeds.

Joel Thornbury’s community pharmacy in Pikeville (provided by Joel Thornbury)
“It’s phenomenal,” Thornbury said of the state’s decision to cut out the brokers known as pharmacy benefit managers, or PBMs — private entities that work as subcontractors to health plans and decide how much to pay pharmacies and which drugs to cover.

“You just make my life easier and cut down on the number of people I have to talk within the insurance industry.”

What’s more, it’s saving the state money — a lot of money — by putting Medicaid prescription management under single vendor, Medicaid officials recently told a state legislative committee.

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