For that reason, I worry that if Congress continues to push for additional price controls in the prescription drug market, the chances of ever finding a cure for Alzheimer’s—and a range of other diseases—will diminish. We don’t even yet fully know the impact of the IRA’s price-setting policies, and lawmakers should not rush to give the government even more control over setting prices for medicines.
If Congress truly wants to do something to help patients, then lawmakers should look into curbing the abusive practices of Pharmacy Benefit Managers (PBMs), who have an inordinate amount of power and control over what patients pay at the pharmacy. These health care middlemen own or are owned by insurance companies. Just three PBMs control about 80% of prescriptions right now, and they use that power to dictate where and when patients can get their physician-prescribed medications, treatments and therapies.
Worse still, PBMs will often shirk their responsibility to patients in order to boost their own profits. Instead of passing down the savings they negotiate from drug manufacturers to help reduce patients’ out-of-pocket expenses, PBMs and insurers will simply keep those savings for themselves, as they’ve admitted. Ultimately, that means vulnerable patients continue paying higher out-of-pocket costs for their prescriptions while middlemen rake in the profits.
Reforming these harmful PBM practices will benefit patients far more than government prescription price setting—and will do so without threatening the biopharmaceutical innovation patients like me are depending on.