Dear Editor, I appreciated VTDigger’s recent article on Vermont’s consideration of joining the ArrayRx prescription discount card program. Efforts to make medications more affordable are important, and pharmacists share that goal. However, it is essential to understand how these programs function and who ultimately bears their financial impact. Community pharmacies do not set drug prices. We must purchase medications at market rates, maintain facilities, employ licensed professionals and meet strict regulatory requirements to dispense medications safely. These operational costs are real and unavoidable. READ MORE Discount card programs such as ArrayRx do not reduce the prices pharmacies pay for medications. Instead, they establish reimbursement rates through third-party administrators, which may include administrative fees. These administrators do not purchase or dispense medications but still receive compensation for processing the transaction. Meanwhile, the pharmacy assumes all financial and operational responsibility. In some cases, pharmacies make only a few cents of gross margin on a prescription – sometimes less than the cost of the dispensing vial itself – before accounting for staff, rent, utilities and other essential expenses. A useful analogy is agriculture. Even though farmers grow their crops, those crops are not free to produce. Farmers must invest in land, equipment, labor, storage and transportation to safely deliver their product.  Similarly, pharmacies must maintain the infrastructure and professional staffing necessary to dispense medications safely. Focusing solely on the cost of acquiring products while disregarding the operational costs of delivering them does not reflect the true cost of providing care. Pharmacists are also among the most accessible health care professionals. We routinely provide counseling, answer clinical questions and ensure medication safety without appointments or direct reimbursement for these services. Programs like ArrayRx may lower out-of-pocket costs for some patients at the counter, but they do not address the underlying structural issues that drive drug pricing. Any solution should ensure that community pharmacies remain financially sustainable so they can continue serving Vermont patients. Marc Cote,  Brattleboro, Vt. Read the story on VTDigger here: Marc Cote: Who pays for prescription discount cards?. ...read more read less