THE UNSEEN COSTS OF BANNING PBM-OWNED PHARMACIES IN TENNESSEE
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What are pharmacy benefit managers?
PBMs play a central role in the prescription-drug market, handling claims, negotiating prices, and building pharmacy networks for health plans. They are part of a large, highly intermediated system in which scale, contracting, and integration are normal features rather than exceptions.
While they can create real efficiencies in a complex prescription-drug market, critics argue the system is opaque and dominated by a few large firms, squeezing independent pharmacies and frustrating patients. The key policy question is whether concerns about PBM behavior justify banning vertical integration outright, or whether states should instead target specific harmful practices directly. As health care economist
The FAIR Rx Act would go further, prohibiting PBMs from directly or indirectly owning or controlling pharmacies beginning in 2028. A separate bill would raise reimbursement floors and tighten payment rules further. The question is no longer whether to regulate PBMs, but whether to prohibit vertical integration in this sector and accept the costs that result.
The statewide tradeoffs of PBM bans
In "The Seen and the Unseen," Frederic Bastiat warned that bad policy often broadcasts its visible effects while concealing real costs. The seen effects of a PBM-pharmacy ban are obvious enough: legislators can say they stood up to PBMs; rival pharmacies have less competition; and supporters can claim they've reformed a disliked ownership model. The invisible costs then fall on everyday Americans in the form of higher prices and compliance costs.
If FAIR Rx is signed into law, CVS would be most affected as it is the only PBM-owned retail pharmacy chain in
This bill would not automatically shutter every CVS, though.
CVS is the nearest pharmacy for 29 ZIP codes in
A 2022 study found a median of five annual community-pharmacy visits among commercially insured adults, while higher-need populations visited much more often. Annual burden would depend heavily on how often affected patients use pharmacies, but even conservative assumptions would multiply the per-trip costs quickly.
That is exactly the sort of cost Bastiat considered in "The Candlemakers' Petition." Every dollar spent complying with an artificial constraint is a dollar not spent elsewhere. That is the unseen cost of a PBM-pharmacy ban: resources quietly pulled away from better uses to satisfy a policy with an undetermined cost-benefit tradeoff. Even that possibly understates the disruption, as this data does not capture every Tennessean who would be forced to change behavior under a ban.
People choose pharmacies based on their daily routines and familiarity. Many currently choose CVS instead of other national brands or local pharmacies, for example. Out of the 134 CVS locations in
Localized burdens, concentrated gains
Statewide averages have a way of concealing where the burden actually falls, downplaying how dependent some communities are on CVS. For example, in the city of
County-level data shows the same pattern:
Displaced business would largely shift to other major chains, not new local competitors. Walgreens would become the new nearest pharmacy for eight ZIP codes covering about 275,000 people, while Kroger would gain four ZIPs (covering about 135,000 people), and Walmart three (about 125,000 people).
Policies like FAIR Rx do not eliminate scale or corporate power, they merely shift customers from one large chain to others while patients bear the switching costs.
It is not the government's role to dismantle a lawful business arrangement without clear evidence of consumer harm and proof that narrower remedies would fail. While
Meanwhile,


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