Too many Americans struggle to afford the medicines and health care they need. And the problem has gotten worse in recent years as insurers increasingly use practices that shift costs to patients. But the drug pricing debate in Washington continues to ignore the broader pharmaceutical supply chain, including middlemen like insurers and pharmacy benefit managers (PBMs).
Unfortunately, Congress just passed a law that doesn't stop abusive insurance and PBM practices that are the real drivers of health care costs. Take insulin, for example. Last year, manufacturers provided deep discounts to insurers and PBMs that lowered the cost of the most commonly used insulins by 84% on average. These middlemen – not patients – have been the primary beneficiaries of these deep discounts. Patients deserve better.
Congress could meaningfully address patient access and affordability concerns if they pursued legislation that:
• Included the kind of accountability and transparency of PBMs that patients and employers need.
• Addressed a broken insurance system that is shifting more of the costs of medicines onto vulnerable patients.
• Took steps to ensure patients share in the deep discounts that PBMs and health plans receive.
Giving the federal government unprecedented, sweeping authority to set prices for our medicines was not the solution.
Congress must work on real solutions to make sure patients can afford their medicines at the pharmacy counter. That starts with holding insurers and middlemen accountable.