Wouldn’t it be nice if, after your doctor prescribed a particular medication, you could simply go to your favorite pharmacy and pick up the exact medicine chosen by your physician at an affordable price? Unfortunately, for far too many Georgians, this isn’t how things work – and countless patients are paying for it in higher prices.
Opinion
Here’s why: Profit-driven middlemen called pharmacy benefit managers, or PBMs, which are owned and operated by insurance companies, insert themselves between your doctor and your pharmacist, making decisions that can cost you money restrict access to certain medications. While they were originally created to negotiate better prices and streamline care, PBMs have strayed far from their intended purpose.
After negotiating lower drug prices, PBMs and insurance companies are pocketing the profits, rather than passing the savings along to patients. And while patients have been forced to pay higher and higher costs, PBMs earned record profits – over $200 billion in 2021 alone.
This is especially important to patients who require specific medications but don’t have access to cheaper generic alternatives. In these cases, prescriptions could cost tens of thousands every month. The result? Many patients in Georgia and across the country refrain from taking their medications, cut their pills in half, or will intermittently take their medications.
As a practicing doctor here in Augusta, I see the impact of patients struggling to afford their medications every day. Far too many of my patients don’t get the medicines they desperately need and suffer as a result. We must act now.
Thankfully, one of Augusta’s state legislators, Rep. Mark Newton, is working to bring much needed relief to Georgia patients.
The amount that patients pay for a medicine often based on the full list price of the medicine rather than the deeply discounted amount that the PBMs actually paid. Under his bill, HB 343, the savings negotiated by PBMs to reduce prescription drug prices, called “rebates,” will be shared with patients. These rebate savings will lower prescription drug price at the pharmacy counter.
Representative Newton’s bill enjoys bipartisan support. Republicans and Democrats are coming together to bring reform to this critical area.
Now it’s time for our legislators to put patients first and pass on rebates directly to patients.
Patient health care must be the top priority, not the profits of operators who don’t actually do anything to help those in need. I hope you’ll join me in urging Georgia lawmakers to act swiftly and put patients first this year.
Donna Adams Pickett, Ph.D., MD practices in Augusta.
