McKone: Oklahoma lawmakers are trying to help local pharmacies, but patients are paying the price

In Oklahoma, there is a growing effort among some lawmakers to support independent pharmacies — small, local businesses that have struggled to compete in a changing health care marketplace.

That instinct is understandable.

Independent pharmacies, like many Main Street businesses, have faced years of economic pressure. They are important parts of their communities, especially in rural areas. Wanting to support them is a goal most Oklahomans can agree on.

But good intentions do not always lead to good policy.

Earlier this session, lawmakers advanced a proposal – House Bill 3538 – aimed at helping independent pharmacies by limiting certain business models used by large chain pharmacies and mail-order prescription drug providers. In effect, it would have reshaped the marketplace by pushing out some of the very options many patients rely on today.

That might sound like an industry issue — but it quickly became clear it was much more than that.

For tens of thousands of Oklahomans, including many veterans, mail-order pharmacy services are not a luxury. They are a lifeline.

Many veterans rely on federally administered systems like TRICARE to receive their medications by mail. These programs are designed to ensure consistency, affordability, and access — especially for those managing chronic conditions or living far from a pharmacy.

When concerns about disrupting those services became public, veterans across Oklahoma spoke up.

One of them was Dr. Kelton Oliver, a retired Air Force and U.S. Public Health Service physician from Purcell, who warned, “A disruption in medication can be a really big deal — for some patients, it may be the difference between being okay and ending up back in the hospital.”

To their credit, Oklahoma lawmakers listened. Those provisions were ultimately removed.

Unfortunately, what replaced those provisions (both in HB 3538 and a senate companion, SB 2074) is a mandatory, government-imposed dispensing fee of more than $10 on every prescription filled in Oklahoma.

Call it what it is: a pill tax.

This fee doesn’t come from pharmacies or insurers absorbing costs behind the scenes. It is passed along to patients, employers, and taxpayers.

For Oklahomans managing chronic conditions, that adds up fast. The cost of providing pharmacy benefit services for an Oklahoman getting six prescriptions a month would go up by about $800 annually. And the impact goes beyond individual patients.

According to the state’s own fiscal analysis, applying this model to public employee health plans would cost taxpayers over ten million dollars a year. But that is just a fraction of the total impact. In the private sector, where most Oklahomans receive coverage, the costs would be many times higher — showing up in the form of higher insurance premiums, increased employer expenses, and ultimately, higher costs for working families.

Supporters argue this policy is necessary to support independent pharmacies.

But it does so by requiring every other Oklahoman to pay more for their medications.

That is a tradeoff worth examining closely.

There is nothing wrong with wanting to help local pharmacies. At some point, however, the question becomes: how far are we willing to go?

How much are we willing to take out of the pockets of Oklahoma families — including those who are sick, vulnerable, and dependent on daily medication — in order to support one segment of the health care system?

Health care policy should start with a simple principle: the patient comes first.

Oklahoma lawmakers showed they were willing to listen when veterans raised concerns about access to care.

They should listen again now — because making that care more expensive is not the solution.

Julie McKone is the executive director of Oklahoma Families for Affordable Healthcare.

McKone: Oklahoma lawmakers are trying to help local pharmacies, but patients are paying the price