At Family Outreach Inc., we provide supportive services to individuals with developmental delays or disabilities and their families across western Montana.
This support often includes coordinating health care resources for the benefit of our clients. In today’s complex health care system, people with intellectual disabilities and their families often struggle to find and afford essential health care services and treatments. I believe that everyone deserves transparency and affordability when it comes to health care and prescription medications.
Unfortunately, Pharmacy Benefit Managers have increasingly become obstacles to these principles.
As middlemen in the drug supply chain, PBMs are supposed to negotiate lower prices and ensure patients have affordable access to medications. One would think patients should directly benefit from these lower prices, but that’s usually not the case. Instead, PBM interference often results in higher costs and reduced choice for patients. A recent committee investigation found that PBMs have intentionally overcharged, or withheld rebates and fees, from many taxpayer-funded health programs and then pocketed the difference.
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This is a direct attack on taxpayers, who are left paying more for less.
This investigation also revealed that in these taxpayer-funded programs, PBMs often steer patients to the pharmacies they own, rather than those that may be closer to the patient or provide better service. More than ever, we need meaningful systemic change that eases the financial burden for families and promotes better health outcomes for patients.
Thankfully, there is a bill put forward by Sen. Jon Tester and others to rein in these excesses by Pharmacy Benefit Managers, and he has been public about his support for the issue. The Delinking Revenue from Unfair Gouging Act will prohibit PBMs from making more money on high-cost drugs compared to lower-cost drugs. This change will help to ensure that patients are not being steered toward more expensive medications by PBMs, meaning more patients will be able to afford the care they need. We have a real chance to protect patients from predatory practices and promote transparency in health care. Bipartisan support for PBM reform reflects a widespread recognition of the problem, and with Tester’s continued support of this legislation, it may open the door to other critical reforms.
PBM reform is not only timely but essential for the health and well-being of all Americans. The stakes are too high to allow PBMs to continue operating in the shadows. We all must stand up for the right of patients to receive fair and transparent treatment in their health care.
Please contact Sen. Tester’s office and tell him to continue pushing this issue so we can improve health outcomes for all Montanans.
Jackie Mohler, M.Ed., LBA, is the executive director of Family Outreach Inc.
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Publish date : 2024-09-24 02:00:00
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