BOISE, Idaho — Imagine running a small lemonade stand, and you buy lemons and sugar for one dollar. But when someone buys a cup, you only get ten cents. You’d lose money every time you sold a drink.

That is what small, locally owned pharmacies in Idaho say is happening to them, only it’s with medication instead of lemonade.

The problem, they say, comes from Pharmacy Benefit Managers, or PBMs. These are large companies that act as middlemen between pharmacies and health insurance providers, deciding how much a pharmacy gets reimbursed for filling a prescription.

At Medical Clinic Pharmacy in Caldwell, owner Tyler Higgins said his business is barely hanging on. It’s now the last community pharmacy in the city.

“Because of that, we’re not able to service all the prescriptions that we woul

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