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When patients can't afford the medications they need, they are forced to make difficult choices, often skipping or delaying doses which can lead to poorer health.
Moreover, the economic burden of exorbitant drug prices extends beyond individual households. It affects the entire healthcare system. When prescription drugs become prohibitively expensive, we all pay the price. Lowering drug prices can relieve this burden on individuals and the healthcare system as a whole.
Pharmacy Benefit Managers (PBMs), the intermediaries that negotiate drug prices on behalf of insurance companies, were originally intended to control healthcare costs. Since they were created though, PBMs have increasingly come under scrutiny for their opaque practices that often result in inflated drug prices and higher out-of-pocket spending for patients. Their business practices are a complex web of negotiations and financial arrangements that ultimately leave patients and healthcare providers grappling with higher costs.
To tackle these issues effectively, Congress has held hearings and is considering reforms. This includes measures to increase transparency in drug pricing negotiations, promote competition, expedite generic drug approvals and ensure that PBMs act in the best interests of patients.
This Congress, I have supported the Share the Savings with Seniors Act, HELP Copays Act and the Drug Price Transparency in Medicaid Act.
I was proud to sponsor the Share the Savings with Seniors Act, which aims to ensure that senior patients with chronic medical conditions can directly benefit from the savings negotiated by their insurance plans and PBMs. This legislation seeks to lower out-of-pocket costs for seniors who are often caught in the crossfire of skyrocketing prescription prices and inflation rates.
The bill takes a bold step by passing rebates directly to seniors, offering much-needed financial relief without compromising the quality of their medications. In an era where financial stability and health should not be at odds, this act brings much-needed support to our seniors who have given so much to our society.
I am honored to lead the bipartisan HELP Copays Act, a critical piece of legislation designed to shield patients from insurance and PBM practices that drive up patient out-of-pocket drug costs. The bill addresses the "copay accumulator" schemes used by health plans and PBMs to absorb patients' copay assistance, effectively excluding it from counting towards deductibles or out-of-pocket maximums.
By requiring health plans and PBMs to consider the value of copay assistance in meeting a patient's cost-sharing requirements, the HELP Copays Act preserves the true intent of copay assistance programs.
I was also a cosponsor of the Drug Price Transparency in Medicaid Act, a robust effort to bring transparency and fairness to Medicaid programs by eliminating the wasteful and predatory spread pricing tactics employed by PBMs. These tactics result in lower reimbursement rates for pharmacies and artificially inflate healthcare costs.
This legislation promises substantial savings for taxpayers by ending the use of spread pricing in Medicaid programs. It establishes oversight and accountability for PBM practices that jeopardize patient access to healthcare and drive-up prescription drug spending. By tackling these issues head-on, the act ensures that Medicaid funds are used efficiently and that patients receive the care they need without undue financial strain.
In conclusion, the urgent need to lower prescription drug prices cannot be overstated. It's an issue that impacts the health and financial well-being of millions of Americans. The Share the Savings with Seniors Act, HELP Copays Act, and Drug Price Transparency in Medicaid Act represent significant steps toward achieving healthcare affordability and accessibility for all. Lowering drug prices is a goal worth pursuing, and these bills offer a prescription for relief for countless Americans.
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