Don’t eliminate pharmacy benefit managers


Since the Affordable Care Act, it seems like the health care issue gaining the most momentum is the rising prescription drug costs, especially for the seniors who make up one-third of Payson.

Congress has had about a dozen hearings on the issue already this year.

Everyone from Democrats in Congress to President Trump has vowed to do something to bring down the cost of prescriptions.

But anyone watching last week’s Senate hearings learned that Congress still doesn’t really understand the critical role pharmacy benefit managers (PBMs) play in reducing prescription costs. Some call them “middlemen,” but what they do is negotiate rebates from drug companies. For example, two of the biggest PBMs, Express Scripts and CVS Caremark, pass the vast majority of rebates on to customers. On average, Express Scripts returns 90 percent of rebates and CVS Caremark passes 98 percent of rebates.

It adds up. The average annual per-person savings to a Medicare Part D patient are more than $2,000. They are an important check on drug companies’ skyrocketing prices.

Recently, the administration proposed a new “rebate rule” that would prevent PBMs from negotiating rebates for Medicare. If the rule is implemented, Medicare’s own analysts predict that Part D premiums will go up 25 percent. It would drive seniors’ prescription costs up, not bring them down.

It’s important that our representatives understand how PBMs serve as a check on rising drug prices so they understand how costs will go up if the administration eliminates them.

Becky Jones, Payson

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