Give a summary of your email to your recipients
View online version [link removed]
What are Pharmacy Benefit Managers?
The Bull Moose Project
The battle over Obamacare and its aftermath was legendary – and led to a conservative majority determined to repeal the new health care legislation and replace it with a more efficient, market-friendly measure that balanced the needs of consumers and businesses without extreme government interference.
That plan collapsed with the failed Obamacare repeal in 2017 due to bald-faced lie from Democrats that the legislation Republicans produced would take away access for individuals with pre-existing conditions. And so, healthcare has remained a looming issue in America’s political future; our mandatory government spending is dominated by our healthcare programs, and most Americans hope for lower healthcare and drug costs. Still, we’d expect the two parties to take different approaches.
Yet, three House committees and three Senate committees have moved legislation, with bipartisan support, to regulate Pharmacy Benefit Managers (PBMs). When we dug into the PBM issue itself, this behavior became more inexplicable than we first thought.
Basically, PBMs administer the pharmacy portion of your health insurance. When you pick up a prescription and hand the pharmacist your insurance card, instead of paying whatever Big Pharma companies decide to charge, you pay a lot less.
PBMs negotiate with pharmaceutical manufacturers to secure lower prices using economies of scale and other market mechanisms. A study by the National Bureau of Economic Research estimates [[link removed]] that PBMs deliver $145 billion in value every year, concluding, “PBM negotiations fuel competition that lowers retail and manufacturing prices.”
This seems like a good thing for Americans.
Even better, PBMs improve health outcomes by ensuring patients have access to the most appropriate drugs for their needs. Again, when you go to fill that prescription, your doctor might have made a mistake but the PBMs will alert the pharmacist to any potential prescribing errors, negative drug interactions, incorrect dosages, or other issues. In this way, PBMs prevent nearly half a million [[link removed]] heart failures every year, along with other tragic consequences.
In addition, PBMs notify pharmacists when it’s time for a patient’s refill, so they take their prescriptions as necessary. A lot of this is also done through home delivery by PBMs so it’s super easy and convenient. According to one study [[link removed]], “Approximately 125,000 deaths per year in the United States are due to medication non-adherence and between 33 and 69 percent of medication-related hospital admissions in the U.S. are due to poor adherence.”
Medication non-adherence leads to poor outcomes which, in turn, increases the need for healthcare services and, therefore, overall healthcare costs. Detailed analysis shows [[link removed]] that up to $300 billion of annual healthcare spending in America could be avoided with the better outcomes achieved through improved medication adherence.
It’s understandable why Democrats would hate PBMs. They are trying to break the healthcare system to make way for socialized medicine. Bernie Sanders, Chair of the powerful Senate Health, Education, Labor, and Pensions (HELP) Committee, has repeatedly introduced [[link removed]] “Medicare for All.” He has the support of all the Progressives in the House as well.
The strange part is that some Republicans are equally fanatical about targeting PBMs. The opposition to PBMs seems to rely heavily on talking points drafted by Big Pharma companies and their lobbyists in Congress. Although PBMs have received increased scrutiny over the years on topics ranging from transparency to market competition, they are often the only buffer between Americans and Big Pharma’s abusive drug prices.
On the other hand, some Republicans like Rep. Eric Burlison and Sen. Rand Paul really get it. Congressman Burlison said at one hearing [[link removed]] that targeting PBMs “will only benefit big pharma” by letting them make “even more profits than they do today.” Senator Paul wrote [[link removed]], “The truth is the left’s bill is being rammed through the Senate because some special interests want to weaken PBMs. Drug companies don’t like that PBMs have the size and bargaining power to cut into their profit margins.”
Pharmaceutical companies are trying to deflect blame for high costs onto PBMs. Drug makers have a big voice, in Washington and in the media. Next time you watch the news, pay attention to the number of ads you see for various medications. The pharmaceutical industry spends more on advertising [[link removed]] than any other industry, so the media is in their pocket. And, they spend more on lobbying [[link removed]] than any other industry as well.
So, either because they believe what they hear in the media or from lobbyists, some Republicans are following the Democrats over a healthcare cliff into the socialized medicine abyss.
Sincerely,
The Bull Moose Project Team
--------------------------------------------------------------------------------
[[link removed]]
--------------------------------------------------------------------------------
This e-mail has been sent to
[email protected], click here to unsubscribe [link removed].
300 Independence Ave SE 20003 Washington US
