Commissioner Trent Hatley 

As inflation squeezes our wallets, concerns over the cost of healthcare loom large for North Carolina families. A recent survey showed that 54% of state residents worry about affording medications, with nearly a third resorting to skipping doses or refusing to fill prescriptions to save money. These numbers underscore the urgency of creating a more affordable, high-quality healthcare system in our state. 

Sadly, instead of pursuing viable solutions, we’re seeing attacks on Pharmacy Benefit Managers (PBMs) that will ultimately raise costs on prescriptions for patients and employers. 

Employers – large and small – choose to work with PBMs for a number of reasons. PBMs consistently drive down drug costs through negotiations with pharmaceutical manufacturers, and it’s estimated that they save patients an average of $1,040 each year, with every dollar spent on their services resulting in $10 in cost reductions. They also improve patient care by administering and coordinating essential services in partnership with healthcare plans and employers.   

The cornerstone of a vibrant healthcare market lies in competition and minimal government intervention. In a world where innovation and choice drive progress, PBMs help to provide that in North Carolina. 

Through these government health care proposals, we could see the imposition of new mandates to prevent patients from navigating many prescription drug options. Vital services like lower-cost pharmacy networks and home delivery of prescriptions could vanish, particularly impacting rural and needy communities that rely on these choices for accessibility. 

To make matters worse, some proposals would impose fees on the majority of prescriptions, effectively serving as a handout to special interest pharmacies while burdening patients, especially those grappling with chronic conditions. This out-of-pocket cost quickly adds up for hard-working North Carolina families, causing them to spend significantly more with each new visit to the pharmacy counter.  

North Carolina employers deserve the latitude to tailor insurance coverage to suit their specific needs, unencumbered by overbearing regulations. But if we add more government red tape, we risk limiting the choices of businesses and forcing them to pay higher premiums.  

With nearly half of North Carolinians receiving their healthcare from employers, we can expect any rising healthcare costs to be passed on to employees. In a recent survey, a majority of employers (73%) acknowledged that high healthcare costs produce lower wages and salaries, and 9 out of 10 cited drug prices as a threat to affordable employer-sponsored health coverage.  

Employers operate in an increasingly competitive environment where profit margins are thin and where every possible saving, including healthcare costs, make a big difference. With the price of providing health insurance to employees escalating for small businesses, any measures that would increase those costs will only compound existing issues. 

As the North Carolina legislature convenes for a new session, lawmakers should focus on the root causes of our soaring healthcare costs – not launch unwarranted attacks on vital institutions like PBMs. Hopefully, our legislature will be focused on holding drug manufacturers accountable for arbitrary costs and demanding greater transparency in their drug pricing.  

North Carolina cannot afford to implement pricey policies that will increase costs for patients, hike premiums for employers, and burden taxpayers. Let’s urge our state lawmakers to seek more sensible remedies to our healthcare challenges.