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Arroyo: Reform needed with pharmacy benefit manager practices


As a single mother of two, I’ve dealt with a variety of medical concerns over the years. One of my sons is now on medication to treat his ADHD, which he was diagnosed with this year. The high out-of-pocket costs that come with his prescriptions are a constant reminder that some aspects of our health care system desperately need to be fixed.

Congress should start by doing something to address the harmful impact PBMs — Pharmacy Benefit Managers — have on patients and out-of-pocket prescription costs. These insurer-owned groups have too much control over deciding when and where patients can access the vital medications and treatments they need. PBMs practices like prior authorization and patient steering help them cut costs and increase profits while delaying access to timely care.

Even more reprehensible in my opinion is the fact that PBMs will go out of their way to secure drug discounts and savings from manufacturers only to turn around and keep those savings instead of sharing them with patients to help reduce out-of-pocket costs. It is well past time for Congress to step in.

That’s why I’m glad to see legislation has been introduced in the Senate that would help solve this problem. If passed, the D.R.U.G. Act would help reform the harmful PBM practices that lead to reduced access and increased out-of-pocket expenses for patients. Sen. Sinema should help pass this much-needed bill and Rep. Biggs should work to ensure the House follows suit.

letters, opinion