Op-Ed: Why PBM Reform Matters for NEPA Patients

As Northeastern Pennsylvania’s health care system grows more fragile, Rep. Rob Bresnahan deserves credit for confronting one of the root causes. In the December 3 Times Leader article reaffirming his commitment to improving health care in NEPA, he highlighted the urgency of strengthening access and stability across the region.

Hospitals in NEPA are teetering on the brink of closure or major service cuts, putting emergency care, surgeries, and routine services at risk for families who cannot travel far for treatment. At the same time, community pharmacies are disappearing at an alarming rate.More than 1,100 licensed pharmacies have closed statewide since 2020, including roughly 22 in Luzerne County and 21 in Lackawanna County, according to the Independent Pharmacies of NEPA.

One of the biggest drivers of the problem: the lack of transparency and accountability among pharmacy benefit managers, or PBMs. PBMs control which medications are covered, what patients pay, and how much pharmacies are reimbursed, yet their practices largely operate out of public view.

When pharmacies close, patients face delayed prescriptions, longer travel times, and fewer options for vaccinations and chronic disease management. These losses push more patients into already-strained hospitals.

The Pennsylvania legislature has attempted to address PBM transparency, but with limited success. Real PBM transparency and reform are essential to stabilizing hospitals, keeping pharmacies open, and protecting patient access in NEPA.

Rep. Bresnahan’s leadership is an important step. Now lawmakers must act to ensure health care dollars support patients, not middlemen.