Evidence map›Paper›PMID 42774826›Full record

ArticleHealth affairs scholar2026

Pharmacy benefit manager policy and pharmacy stakeholder perceptions of financial pressures and closures.

Jennifer L Bacci, Natalia Oster, Benjamin S Dunlap, Susan M Skillman, Bianca K Frogner

Abstract read
In one paragraph

Article in Health affairs scholar, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jennifer L BacciUniversity of Washington School of Pharmacy, Center for Pharmacy Practice Tranfromation, Seattle, WA 98195, United States.ORCID https://orcid.org/0000-0001-9944-6050
Natalia OsterDepartment of Family Medicine, University of Washington School of Medicine, Center for Health Workforce Studies, Seattle, WA 98195, United States.ORCID https://orcid.org/0000-0002-4366-403X
Benjamin S DunlapDepartment of Family Medicine, University of Washington School of Medicine, Center for Health Workforce Studies, Seattle, WA 98195, United States.ORCID https://orcid.org/0000-0002-2160-8141
Susan M SkillmanDepartment of Family Medicine, University of Washington School of Medicine, Center for Health Workforce Studies, Seattle, WA 98195, United States.ORCID https://orcid.org/0000-0001-8191-6771
Bianca K FrognerDepartment of Family Medicine, University of Washington School of Medicine, Center for Health Workforce Studies, Seattle, WA 98195, United States.ORCID https://orcid.org/0000-0002-5120-1828

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The community pharmacy workforce provides access to medications and services, yet financial pressures and pharmacy closures threaten patient access. Pharmacy benefit managers (PBMs) influence medication reimbursement and are frequently cited as contributors to financial strain. States have enacted legislation to regulate PBM practices. This study examined state PBM laws from 2015 to 2025 and pharmacy stakeholder and workforce perceptions of factors influencing closures. Methods: Enacted state PBM legislation from 2015 to 2025 was identified using the National Academy for State Health Policy and the National Conference of State Legislatures databases and analyzed descriptively. Thirteen key informant interviews were conducted with pharmacy organization leaders and pharmacists with firsthand closure experience. Interviews focused on system-level contributors to closures and were analyzed using rapid content analysis. Results: Pharmacy benefit manager regulation expanded from 2 states in 2015 to all 50 states by 2023. Interview participants perceived PBM practices as a major contributor to financial instability and low workforce morale. While PBM policies were viewed as necessary, participants cited inconsistent enforcement and limited workforce relief. Conclusion: Despite regulations, PBM practices are perceived as key drivers of financial pressures and closures. Strengthening policy implementation and enforcement may help sustain the workforce and preserve access to care.

Indexed as

community pharmacy servicesmedication accesspharmacy benefit managers

Identifiers

PMID42774826
PMCPMC13594649

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.