According to several estimates, Americans die younger and are less healthier than individuals in other industrialized countries, while spending thousands more on healthcare. This is the reason why a lot of Americans are so incensed at a system that appears to prioritize corporate profits over providing medical care to those in need.
Why is the question? While Canadians, British, Germans, and Australians enjoy superior healthcare for far less money, why are millions of sick Americans burdened with mountains of medical debt?
The clue is included in three small letters: PBMs. Pharmacy benefit managers (PBMs), according to patient advocates, are businesses that function as a middleman between pharmaceutical firms and those who require their medicines.
PBMs are meant to assist health insurance companies in negotiating reduced prescription costs, but patient activists contend that this is not the case.They contend that any savings they are able to negotiate with Big Pharma remain in their own pockets and are not transferred to customers. Additionally, there are smoke and mirrors surrounding the entire price structure.
Six of the biggest pharmacy benefit managers in the country are a part of bigger healthcare conglomerates, as illustrated in a Federal Trade Commission chart.(Source: FTC)
The goal of this bipartisan group of senators and congressmen is to shed some light on a system that is extremely dark. According to the Federal Trade Commission (FTC), PBMs have misused their economic power by manipulating pharmaceutical supply chain competition to their advantage, forcing consumers to pay more for life-saving drugs, they write in a letter to the leaders of the House and Senate.
These lawmakers are listening firsthand from irate citizens who feel that PBMs are largely to blame for the dysfunction in this nation’s healthcare system.
Legislators in Pennsylvania have made significant progress in reforming PBM practices in our commonwealth, but patient advocates argue that federal legislation is required to increase openness regarding PBM operations and lower the exorbitant cost of many prescription medications that save lives. In order to assist individuals like Maria Shoemaker, the congressmen and women are requesting that the House and Senate leaders enact legislation this month.
Shoemaker explained to the Editorial Boards of PennLive and The Patriot-News that she had to spend thousands of dollars on medication to prevent her death for 15 months due to a rare blood disorder. Additionally, she was unable to pay for necessary procedures, so she had to forgo them. She was denied coverage for the medications she sorely needed by a PBM that stood between her and the insurance provider.
Alongside patients like Shoemaker, independent pharmacists like Chris Antipas are calling on Congress to change PBM practices. The Pennsylvania Pharmacists Association is led by Antipas. He informed our Editorial Board that one of the main causes of the closure of several independent pharmacies is PBMS.
Independent pharmacist Chris Antipas is advocating for changes to pharmaceutical benefit managers’ procedures. He wants the process by which they bargain over the cost of prescription drugs to be more transparent.Zoom image
Pharmacists would like to see greater openness in the way PBMS sets medicine prices. They claim that because many PBMs own their own pharmacies and have stakes in pharmaceutical firms, in addition to negotiating prescription drug pricing, the entire system need greater control and regulation. As Antipas correctly points out, a lot of PBMs have significant conflicts of interest that benefit their own pockets at the expense of sick and vulnerable patients.
In the United States of America, things don’t have to be this way. We stand with Shoemaker and Antipas in calling on lawmakers to take action before the holidays to control PBMs and lower prescription drug costs for all Americans.
To ensure that legislation to reform PBMs is passed right away, we implore all of Pennsylvania’s senators and representatives in Washington to join the bipartisan effort. This holiday season, millions of Americans are struggling to pay for the medication they need to keep alive, and we need to alleviate their anxiety.
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