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Inside the battle over prescription drug prices and pharmacies in the Louisiana Legislature

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Inside the battle over prescription drug prices and pharmacies in the Louisiana Legislature


Independent pharmacies gained the upper hand Wednesday against pharmacy benefit managers following a behind-the-scenes lobbying battle over what has been one of the biggest unsettled policy issues in the final days of the regular legislative session.

The outcome could affect everyone in Louisiana who buys prescription drugs, especially those who purchase specialty drugs that treat such maladies as diabetes, neuropathy and inattention or hyperactivity.

Pharmacy benefit managers are third-party companies that are supposed to negotiate lower drug prices by acting as middlemen between drug manufacturers, insurance companies and pharmacies. Critics say that pharmacy benefit managers pocket too much of the savings.

A measure passed Wednesday by the Senate Insurance Committee, House Bill 264, favored independent pharmacies by prohibiting pharmacy benefit managers from steering customers to pharmacies they own and by mandating that discounts negotiated by pharmacy benefit managers go to employers and consumers. HB264 also requires pharmacy benefit managers to report more details of their activities to government regulators to ensure that they are following the law.

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“Today the balance has shifted away from large corporations and their profits back to independent pharmacies and the consumers,” Sen. Adam Bass, R-Bossier City, said in an interview following the insurance committee hearing.

Gov. Jeff Landry has sided with the independent pharmacies, saying when he opened the legislative session nearly two months ago that he favors “reining in the PBMs who are driving the cost of prescriptions.” Landry pitched his views to Republican senators Monday night in the Senate basement, according to senators.

Lobbyists for pharmacy benefit managers had lobbied against HB264 but accepted the changes as inevitable, legislative sources said, to try to head off Louisiana from following Arkansas and adopting more far-reaching legislation that would prohibit pharmacy benefit managers from also owning and operating pharmacies.

Landry also supports that change, according to his staff.

CVS, the biggest drug store company that owns a pharmacy benefit manager, sued Arkansas a week ago to block the new law there from taking effect. CVS has 23 pharmacies in Arkansas but more than 100 in Louisiana.

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The CEO of Caremark, CVS’ pharmacy benefit manager, tried to sway legislators in Louisiana with phone calls, legislators said. The CEO of Optum Rx, another pharmacy benefit manager, came to Baton Rouge to personally lobby lawmakers.

A state website shows that CVS has seven lobbyists working the halls of the State Capitol. They are working in alliance with lobbyists for the Pharmaceutical Care Management Association.

“PBMs secure savings on prescription drugs for Louisiana employers and patients and provide employers with a wide range of choices to offer quality prescription drug coverage,” said Greg Lopes, a spokesperson for the association. “Drug companies set drug prices, and the prices are the problem.”

CVS declined to comment, saying the company is still digesting the last-minute changes to HB264.

The Louisiana Association of Independent Pharmacies and their allies have their own phalanx of lobbyists.

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“PBMs shouldn’t be allowed to say one thing and do another behind the scenes,” said Randal Johnson, president of the Louisiana Independent Pharmacies Association. “HB264 attempts to shine a light on rebate flows, bans hidden fees and ensures that what’s paid and what’s reimbursed can actually be traced and reviewed. That’s good policy, and more importantly, it’s pro-patient.”

The heavy lobbying by both sides caught the attention of legislators.

“Every lobbyist here is hired,” said Rep. Dustin Miller, D-Opelousas. “You have CEOs from these companies flying in. There are meetings happening in every room of this building.”

Pharmacy benefit managers have become in vogue only in the past dozen years but have quickly faced questions for their activities.

The New York Times reported in a three-part series last year that pharmacy benefit managers operate in an opaque fashion and “are driving up drug costs for millions of people, employers and the government.”

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The Trump administration and Congress are moving to adopt less favorable rules for pharmacy benefit managers.

Wednesday’s action is not the final word in the long-running battle in Louisiana between the independent pharmacies and their allies on one side and the pharmacy benefit managers on the other.

The full Senate still needs to approve House Bill 264, and the House would need to agree to the changes made by the Senate before adjournment on June 12.

In the meantime, a separate House measure, House Bill 358 by Miller, could be amended to institute the change that CVS strongly opposes – a prohibition on pharmacy benefit managers from owning or operating pharmacies. House and Senate negotiators are scheduled to meet in the next several days to decide on the final shape of HB358.

“I support any legislation that will stop the anti-competitive practices that I think PBMs do,” Miller said in an interview.

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Rep. Mike Echols, R-Monroe, and the sponsor of HB264, also takes a skeptical view of the pharmacy benefit managers.

“We’re putting money into the hands of consumers, which should lower costs,” he told the Senate Insurance Committee.

Driving HB264 forward has been Bass, a 44-year-old Allstate agent who is the vice chair of the insurance committee. Sen. Kirk Talbot, R-Harahan, the committee chair, deputized Bass to try to fashion a bill that could win legislative approval.

Bass said he concluded that pharmacy benefit managers were using their power to block some drugs from coming to market and that employers and consumers are not receiving enough of the discounts negotiated by pharmacy benefit managers with drug manufacturers.

Bass said he met with lobbyists from all sides and worked until midnight with legislative staff late on Monday and Tuesday night to confect the final language for changes in HB264.

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The amendments were not shared with lobbyists and some lawmakers until just before Wednesday’s meeting. Echols was quickly familiarizing himself with the changes to his bill just before he presented it Wednesday.

Once the hearing began, Bass explained the changes. A half hour later, the committee approved the amended bill without objection.

The lobbyists on both sides of the issue got up to depart, leaving behind a nearly empty room as the Senate committee moved onto less controversial measures.



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Louisiana

Neuty, the beloved Bucktown nutria rat that charmed Louisiana, has died

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Neuty, the beloved Bucktown nutria rat that charmed Louisiana, has died


Neuty, the iconic Bucktown nutria visits the state capitol, with Myra Lacoste, Denny Lacoste, Lieutenant Governor Billy Nungesser, Dennis Lacoste Sr., and Louisiana state Senator J. Cameron Henry Jr. Neuty was an orphan, rescued by the Lacostes. In March 2023, LDWF agents attempted to confiscate the illegal pet.  



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Louisiana State Police arrest 18-year-old in Vidalia crash t…

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Louisiana State Police arrest 18-year-old in Vidalia crash t…


VIDALIA, La. — Louisiana State Police arrested 18-year-old Gregory Steele early Sunday morning on two counts of vehicular homicide, one count of underage operating a motor vehicle while intoxicated, one count vehicular negligent injuring and one count careless operation, according to Concordia Parish Jail records.

Steele, 18, a white male, was arrested in connection with an accident that occurred at approximately 1:54 a.m. on Sunday morning on Minorca Road in Vidalia. Two passengers in the vehicle were killed. Steele and another passenger were able to escape the vehicle.



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On this Mother’s Day, three Louisiana mothers grieve the deaths of eight of their children, seven killed by their own father | CNN

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On this Mother’s Day, three Louisiana mothers grieve the deaths of eight of their children, seven killed by their own father | CNN


Christina Snow bends down and whispers something in her daughter’s ear as the 11-year-old lies in a white casket, eyes closed as if she were simply asleep.

On the morning before Mother’s Day, Sariahh Snow’s small, lifeless body is one of eight – all children – lined in open white caskets along the front of a church hall in Shreveport, Louisiana.

Except for the low murmur of church organ music drifting through the sanctuary, Snow’s muffled sobs momentarily silence an audience of hundreds who have gathered to grieve alongside the three mothers whose children were all fatally shot by the same man: the father of seven of the eight killed and an uncle to the eighth.

The shocking act of violence, which also left two of the mothers seriously wounded, marked the nation’s deadliest mass shooting in more than two years, a catastrophe so staggering it forced an already grief-stricken country to once again confront the deadly collision of a mental health crisis and America’s unrelenting access to guns.

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“This is not a Shreveport mourning,” Congressman Cleo Fields said in his tribute. “This is a nation mourning.”

Now remembered as the “Eternal 8,” Jayla Elkins, 3; Shayla Elkins, 5; Kayla Pugh, 6; Layla Pugh, 7; Mar’Kaydon Pugh, 10; Sariahh Snow, 11; Khedarrion Snow, 6; and Braylon Snow, 5, were killed in the April 19 shooting.

As grieving attendees lined up to pay respects to the children, one woman shut her eyes after peering at one of the children, Kayla, who wore a white dress, her fingernails carefully painted pink. Just behind her body stood a photograph from when she was still alive, her sweet, wide eyes impossible to reconcile with the stillness of the tiny body in the casket.

Inside the funeral pamphlet, Kayla is described by her family as “K-Mae,” a sweetheart with a big smile who never asked for much, but when she did, melted hearts. She loved “going to school, playing with her sisters, brothers, and cousins, and being outside running, jumping and even wrestling with those she loved.”

The seven other entries read as sweetly. Sarriah was described as “sunshine,” a creative, smart, and loving girl. Khedarrion loved helping his family and adored his principal. Braylon was sweet and gentle. Mar’Kaydon, or “K-Bug,” was a cheerful child who loved telling his grandmother what he learned at school every day. Jayla, also known as her family’s “little J-Bae,” taught her family “more about unconditional love, strength and resilience than words could ever express.” Shayla was warm and quiet. Layla adored her siblings and cousins so much she “would stand up for them no matter how big the other person was.”

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It’s a tragedy that sends chills racing down your spine and leaves a lump in your throat. Throughout the hall, people clung tightly to one another, wiping away each other’s tears. Children filled the pews — sweet, innocent and suddenly feeling even more precious to everyone there.

The Saturday funeral service was carried by the reverberating melody of gospel music that rattled through the hall like waves, sending prayer hands into the air and tears spilling from the eyes of loved ones and strangers alike.

But there were smiles too; and white, pink, blue, and purple bloomed in the crowd of black funereal clothes, woven among bright dresses, pressed shirts, ribbons and flowers.

“Lord, we ask right now a special prayer for Summer Grove School. Lord God, we pray for Lynnwood Public Charter School,” Pastor Al George said during his tribute, praying for the two schools the children had attended.

“We pray for all of those teachers, those principals; Lord, they need you right now. Those students need you right now. They’re going to school and see empty desks; Lord God, they need you right now.”

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Some of the funeral attendees were family, friends and teachers, and many were complete strangers – people who drove more than 12 hours just to stand witness to the unimaginable loss of children they had never met.

“I had to get here,” Kelvin Gadson told CNN. He had arrived a day earlier, having driven from South Carolina, and attended an open viewing of the caskets at a funeral home – the first time the mothers were able to see their children’s bodies.

But Gadson wasn’t just there to honor the children lost. He came for the children still here, the ones now carrying images no child should ever have to carry. With him were two costumes: Minnie and Mickey Mouse. The kids could pose with them as a distraction from what they’d just witnessed.

“They come out scared. But I’m really here because this violence has to stop. It’s killing our children, our precious babies,” Gadson, the founder of Giving a Child a Dream Foundation, told CNN. “My mission is about preventing gun violence.”

Little ones who came out of the casket viewing with their parents wore expressions of confusion and shock after witnessing eight bodies that didn’t look so different from their own.

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One of the children was Micheal Thomas.

“I’m kind of scared of funerals. I’m scared of the dead bodies, and they were pretty kids,” the 10-year-old said, sounding wiser than his years. “They were little. I wish I knew them, we would’ve been playing basketball, football, it would’ve been so fun.”

His friends at school don’t talk about the children as much as he does, he said. Then he points to his little brother, who hides behind his legs and clings tightly to him. “I care because imagine that was your kid. If it was my brother, I would be dying; I would be down bad.”

One day, he said, he will meet them in heaven and tell them, “Hey! How you doing? I’m doing good. You broke my heart, but I was talking about you.”

He hasn’t cried about seeing their bodies but he knows he will. The tears “don’t want to come,” but when they do, he promised he won’t push them back.

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Plastic trucks and ribbon-wrapped dolls

Days after the shooting stunned Shreveport, a whirlwind of police lights, camera crews and grieving relatives swarmed the neighborhood where the killings unfolded, the streets vibrating with sirens, the air shrouded in questions and disbelief.

But today, the home sits almost unbearably silent.

The main road leading to the Cedar Grove house where the children were killed is under construction. Jagged pieces of cement push through the dirt as orange and white caution cones warn drivers of danger. While less than half a mile away, innocent children received no warning at all before encountering the worst danger imaginable.

Eight balloons sway weakly in the wind above a makeshift memorial – eight crosses staked into the damp ground, covered in handwritten messages. Toys cover the lawn: stuffed animals, plastic trucks, dolls still wrapped in ribbons, left behind for children who will never come outside to claim them.

Besides the permanent stain the massacre has left on the neighborhood, it remains, in many ways, still beautiful — homes resting in the midst of lush green grass, children playing on porches, and neighbors blasting Michael Jackson as a family gathers around a table outside.

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A young girl sits slouched in a chair, chin in her hands, bored. It is a neighborhood that, in quieter moments, feels almost like childhood nostalgia made real — fragile, ordinary, and proof of how quickly innocence can be shattered.

In front of the memorial, a small gray cat sits in the rain before wandering to the front door of the gray and white home, curling near the entrance where blood had been spattered just weeks earlier. The gunman was identified as 31-year-old Shamar Elkins. Shreveport Police Cpl. Chris Bordelon told CNN affiliate KSLA the shootings were “domestic in nature.”

As the shooting unfolded, some of the children tried to escape out the back, a state representative said at an earlier news conference. Bullet holes could be seen in the back door of one of the homes.

Every now and then, a car slows to a crawl before pulling over beside the memorial, the people inside sitting silently behind fogged windows, perhaps reminiscing, perhaps praying, perhaps simply trying to make sense of a loss too enormous to truly understand.

Not far from the now empty home, stripped of the laughter and the innocent chaos of excited children that once filled every room and hallway with life, the three mothers, dressed in all white, sit side by side before the eight caskets.

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Keosha Pugh — sister of Shaneiqua Pugh, the gunman’s wife — walked into the funeral leaning on a cane, a painful reminder of the injuries she suffered after jumping from a roof with her daughter, Mar’Kianna, while fleeing the gunfire. The fall shattered her pelvis and hip. Shaneiqua Pugh escaped physically unharmed, but Snow was shot in the face during the attack.

All three mothers carried the visible weight of trauma throughout the service. Their legs trembled beneath them, their hands and heads shook with anxiety, and at times Snow, in tears, curled into the arms of friends and loved ones.

Prayers were recited over the bodies of their babies after horse-drawn carriages carried the children slowly into the cemetery as mourners followed behind, some arms carrying flowers and others carrying young children.

Roses were gently laid across the caskets before eight white doves were released into the sky, their wings unfurling into the clouds — a cruel irony beside the eight young lives below, cut short before their stories ever had the chance to unfurl at all.

Among the mourners was Dollie Sims, who had met the children when their father brought them to her community programs. She recalls being struck by how deeply loved they were. When she learned of their killing, she said she was stunned and retraumatized.

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“This was reliving the gun violence of my son, who was shot 15 times walking down the street. This is surreal, and as a parent, I think all of us out here are just devastated because what makes this situation so traumatic is that it was by their father, who struggled with mental illness,” Sims said, donning a white fur coat and dress as she waited for the family to arrive at the cemetery.

Her son, who survived, was 19 years old at the time of the shooting.

“This should open the eyes to Shreveport, Louisiana, and Louisiana period, about gun violence and its seriousness, and what we need to do to help this situation to make it safer … We need to advocate and support other families and show up and try to find a way to make it better to keep the next family safe.”

Sims believes the full impact of the tragedy has not fully hit the mothers who have not yet been given time to grieve, she said.

“Mother’s Day is just going to be the beginning of them realizing that those babies aren’t there anymore.”

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A few blocks away from the cemetery, Sharon Pouncy had up a folding table beside the road to sell Mother’s Day gift baskets. She lost her own child years ago, she said, after he became sick.

“I want these mamas to know that every mother is holding them in their hearts today,” Pouncy said from the driver’s seat of her truck. She’s wearing a Minnie Mouse shirt – unbeknownst to her, the character is a favorite of the children she had come to honor.

“We know your pain. Once you feel that loss, it never really goes away, you just …” She pauses, and a sad smile flickers across her face. “Well, you just find a way to live with it forever.”

At the same time three mothers lay their babies into the earth; another mother, years into her own journey of grief, finds herself thinking of her baby too.

A man pulls over and points to a basket he’s interested in buying. A card pokes out from a pile of teddy bears: “I love you, Mom.”

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