Conversations and healthy debate about issues facing our industry and the health care system are critical to addressing some of today’s challenges and opportunities. The PhRMA blog welcomes guest contributors, including patients, stakeholders, innovators and others, to share their perspectives and point of view.
Today, we are pleased to welcome a guest article from Eréndira Mora.
As we near the November election, there are many issues top of mind for voters as they step into the ballot box. However, for patients, caregivers, and their families, one issue will undoubtedly remain a priority — the urgent need for pharmacy benefit manager (PBM) reform.
As a caregiver to an aging loved-one who relies on medications for high blood pressure, anxiety, cholesterol and pain related to recent hip surgeries, I see the patient experience first-hand. I have been a caregiver to her for over two years, and each day, I ensure she makes her numerous doctor’s appointments, stays on top of her prescription regimen, and that she has everything she needs at home. It is not lost on me that patients have a lot on their plate. Too often, it’s more than just an uphill battle to manage their care — it’s a full-time job.
That’s why it’s disappointing to see middlemen like PBMs interfere with patients’ care and make it even more difficult for them to receive the treatments they need. Through their abusive practices, PBMs can deny coverage for a patient’s medication, even if it directly contradicts their doctor’s recommendation. As patients and their families know, time is of the essence when you’re fighting health issues, and any moments wasted by PBMs’ refusal to approve a patient’s treatment can ultimately be life-threatening.
As a caregiver who understands the challenges patients face, I find it beyond frustrating that those in their most vulnerable moments face pushback from greedy PBMs who provide little value to anyone but themselves. For families like mine, especially those on a fixed income, it has become too difficult to manage care while PBMs pull out every stop to drive up their profits at the expense of patients.
While I understand that Congress also has a lot on their plate in the coming months, I hope they will work to hold PBMs accountable for their abusive practices and commit to passing reform that ensures patients are paying what they should at the pharmacy. At this point, we’ve all probably seen a news story or heard from someone we know about the havoc these middlemen cause. The next steps are clear — action must be taken. As November approaches, patients, caregivers, and families across the country will be watching the presidential candidates' stance on PBM reform closely.
Guest Contributor
The PhRMA blog welcomes guest contributors, including patients, stakeholders, innovators and others, to share their perspectives and point of view on issues facing our industry and the health care system.
Guest Contributor
What AARP isn’t telling seniors about MFN
Policymakers should improve patient access and reject price controls
Insurers blame GLP-1s for rising costs. The data tells a different story.
The FTC’s PBM enforcement actions gave us a glimpse behind the curtain; it’s time to let the light in.
Patient priorities in the 2024 election
Health Insurance
PBMs/Insurance
Voters for Cures
Patient priorities in the 2024 election
Patient priorities in the 2024 election