As a clinical pharmacist, it’s difficult to sit by and watch as policies and practices put in place by insurers and pharmacy benefit managers, or PBMs, continue to have such a negative impact on patient access to care, affordability and the future of local, independent pharmacies here in Pennsylvania and nationwide.
While it’s frustrating that Congress failed to pass PBM reform last year, I’m hopeful lawmakers, including Sens. Bob Casey Jr. and John Fetterman, can work to pass the bipartisan DRUG Act. The patient-focused reforms within the DRUG Act would help rein in the unscrupulous business practices PBMs use to profit while chipping away at patient access.
PBMs use policies that maximize their profit while failing to pass along promised savings to patients. Unfortunately, their practices also lead to unnecessary delays and denials of care as well as barriers that patients must work to overcome. Patient steering, for example, is when PBMs will restrict patients to the pharmacies that the PBMs own or are affiliated with — which also pose a threat to smaller, independent pharmacies that have been serving their communities for generations.
Congress should pass this bill to hold PBMs more accountable for their practices that threaten patient access, drive up out-of-pocket costs, and hurt independent pharmacies. Hopefully Pennsylvania lawmakers can help push for these much-needed reforms.
Meghan Cahalane
Mt. Lebanon