It’s time for middlemen to share the savings

Insurers and their pharmacy benefit managers (PBMs) are artificially inflating the price patients pay for their medicine at the pharmacy, keeping the profit for themselves. This practice is unfair and needs to stop. In fact, data shows that these middlemen received more than $140 billion in rebates and discounts from biopharmaceutical companies intended to lower the costs of medicines. However, these savings were rarely, if ever, shared with patients at the pharmacy counter.

Congress must act this year to rein in the middleman’s power and address PBM practices that drive up healthcare costs for patients. Real solutions include:

• Demanding greater transparency. Require full disclosure of the financial incentives PBMs receive – like aggregate rebates, administrative fees, and other payments – so everyone can better understand and benefit from the savings PBMs say they create in the system. But more transparency is not enough.
• Addressing the rebate system. Requiring PBMs and health plans to share the savings they receive on medicines directly with patients at the pharmacy counter could lower patient out-of-pocket costs.
• Prohibiting spread pricing. Save money by ensuring health plans, employers and government programs are getting the best deal possible and not being charged more for medicines than PBMs.

We can’t let this session of Congress end without enacting PBM reforms. Let’s pass legislation that holds PBMs accountable so patients can afford their medicine!