The Pharmaceutical Research and Manufacturers of America (PhRMA) today launched a new ad campaign that continues to shed light on the role of pharmacy benefit managers (PBMs) in driving up health care costs and denying coverage of lifesaving medicines.
The PBM industry claims it fights for lower drug costs. The fact is they often prefer medicines with higher prices because it pads their bottom line, and experts warn this can lead to reduced access and higher costs for patients at the pharmacy counter.Just three PBMs control 80% of all prescriptions in the United States, and the largest PBMs own or are owned by the largest insurance companies. As the new ad spotlights, it’s PBMs that decide what medicines patients can get and what people pay out of pocket. And because PBMs receive fees and rebates often tied to the price of medicines, they have a financial incentive to refuse coverage for lower-priced treatments. Ultimately, it’s patients who pay the price.
That’s why it’s important for Congress to pass strong PBM reforms this year, building on the legislative changes seen in states across the country, that address the real challenges patients experience when they show up at the pharmacy. Fortunately, there are commonsense steps lawmakers can take to help hold PBMs accountable and lower costs for patients, like making sure no one pays more for a medicine than their insurance company.
This is the third installment in a multi-year effort to expose a PBM business model rife with conflicts of interest. Previous ads have shown how insurers and middlemen often refuse to share medicine discounts directly with patients, and how middlemen, insurers and other entities are taking a bigger share of every dollar spent on brand medicines. This latest ad campaign, which includes TV, radio, print and digital ads, focuses on how PBMs decide what medicines to cover based on what’s best for them, not patients.
Get the facts about PBMs here. We will continue to shed light on the impact middlemen have on patients’ ability to access and afford their medicines, and we urge policymakers to deliver meaningful relief for patients this year.