Highest-ranking pharmacist elected to state office in the country is going after PBMs

Native Delawarean Kathleen McGuiness, RPh, went from owner of a small independent pharmacy in the city of Rehoboth Beach, DE, to Delaware State Auditor—a natural progression, in McGuiness’ words.

“Whether you are counting the exact number of pennies or pills, you are holding something accountable,” said McGuiness, who was elected in 2018 as the first female state auditor in Delaware. McGuiness is not only the first pharmacist to be Delaware State Auditor, but she is also the highest-ranking pharmacist elected to state office in the country.

As the “fiscal watchdog,” McGuiness oversees the entire state of Delaware as an independent entity to make sure taxpayer dollars are being used correctly. Recently, she has been working to expose taxpayer waste through pharmacy benefit manager (PBM) misconduct.

As pharmacists are well aware, PBMs serve as middlemen between insurance companies, pharmacies, and prescription drug manufacturers and are supposed to compensate dispensing pharmacies fairly. Instead, they have added layers of secrecy and financial waste to the process through spread pricing, gag clauses, claw-backs, and rebate pumping. Independent pharmacies around the country are closing as a result of PBM wrongdoing.

In a June 2021 report, McGuiness’s office found that the state of Delaware overpaid PBMs for state employees’ prescription drugs by $24.5 million over a 3-year period.

“This is taxpayer money and we are not finished,” said McGuiness. “It’s merely scratching the surface.”

While there is some momentum on this front happening in other states as well, McGuiness said she thinks change needs to be initiated on the federal level.

“To have your community pharmacist gone is losing something crucial in your community,” said McGuiness. Health care providers and patients should not be the ones being harmed; there is no way to justify that, according to McGuiness.

A bill in Delaware that addresses PBM reform is awaiting the governor’s signature.

The bill takes into consideration at least one of the recommendations from the June 2021 Delaware State Auditor’s report, said McGuiness. “We gave it some oxygen or at least we hope we gave the legislation some oxygen and we really hope something materializes.”

Loren Bonner, senior editor