North Carolina is the most expensive state for healthcare in the country. At the same time, many people in our state rely on rural or independent pharmacies for access to care and medicine. 

In light of this, the General Assembly embarked on a massive undertaking: finding a way to support rural and independent pharmacies in the face of rising challenges, while also lowering the cost of health care. 

This was not easy to do, but thanks to the hard work of state Sen. Benton Sawrey and state Rep. Heather Rhyne, North Carolina just passed a sweeping, first-in-the-nation bill that addresses this challenge head on.  

The SCRIPT Act, as it is called, is a major win for access and affordability. 

Here is what it does. 

The bill makes sure consumers receive the benefit of prescription drug rebates at the pharmacy counter. Before, those rebates could be kept by a payer to offset other costs. Now they will go directly to the patient. 

The bill greatly increases transparency into all actors in the prescription drug supply chain. It shines a light on Pharmacy Benefit Managers (PBMs), Pharmacy Services Administrative Organizations (PSAOs), and prescription drug pricing. 

The bill allows isolated rural and urban pharmacies to pursue and enter into unique contracts to better serve their communities. For example, these pharmacies can be reimbursed at higher amounts to ensure certain drugs are kept in stock. Or they can partner with plans to serve as a front door to the health care system by screening for conditions like diabetes, high cholesterol, or hypertension. Before, if you wanted to offer these benefits to a rural pharmacy, you had to offer them to every pharmacy in a statewide network. This made the cost unaffordable. Now, these benefits can be narrowly tailored to ensure better access while balancing consumer affordability. 

And finally, the bill prohibits PSAOs from requiring independent pharmacies to buy more expensive drugs from certain wholesalers when less expensive options are available. This will help make sure consumers are getting access to the lowest cost when they go to their pharmacy. 

With the passage of this bill, no state in the country has greater transparency into the prescription drug supply chain, or has enacted more consumer-friendly policies to support independent pharmacies, than North Carolina. 

It was a big challenge, but the hard work of Sawrey, Rhyne, and others has delivered a big win for access and affordability.