I am glad to see Congress finally taking steps to address the overwhelmingly negative impact pharmacy benefit managers (PBMs) have on prescription drug access and affordability. As someone who takes prescription medications regularly, I am tired of paying higher and higher out-of-pocket expenses due to the unfair practices these entities have been able to get away with for far too long.
Fortunately, Sen. Tom Carper, D-Del., and other members of the Senate Finance Committee recently passed a bipartisan bill that would address this issue by a nearly unanimous vote. If passed by the full Senate, and eventually Congress, the Patients Before Middlemen Act would help reform pharmacy benefit manager practices that threaten access and lead to higher out-of-pocket pharmaceutical expenses for patients.
As the title of the legislation suggests, these agencies are, in fact, the middlemen of the health care industry, working between insurance companies, drug manufacturers and local pharmacies. These groups control 80% of the prescriptions on the market today and can essentially dictate when and where patients can access their prescriptions, using harmful policies like patient steering and prior authorization.
The act will go a long way in reining in and reforming PBMs, holding them more accountable for the practices they use to boost profits, all while they undercut access and drive up out-of-pocket costs for patients. I’m thankful to Sen. Carper for his support of this much-needed legislative fix. Legislators should pass the act, or some sort of reform bill, as soon as Congress is back in session.