I am disappointed that members of both the North Carolina State House and U.S. House of Representatives are considering passing legislation that will allow major drug companies to increase prescription drug prices to record highs.

HB 246 (in the statehouse) and HR 2816 (in Congress) would use the heavy hand of government to regulate companies known as Pharmacy Benefit Managers (PBMs).

The State of North Carolina employs PBMs to manage its health care plans and ensure that the pharmaceutical industry provides plan beneficiaries with the best deal possible. So do most private employer health plans; in fact, over 90 percent of Americans with prescription drug coverage are on a plan that uses PBMs. There’s a reason that the vast majority of the country utilizes PBMs: they are extremely effective.

Doug Josephson, RPh, a clinical pharmacist, recently noted that “in the face of rising prices, PBMs provide an affordable, competitive pharmacy benefit for millions of Americans.”

A 2019 study from the Government Accountability Office, the federal government’s apolitical auditor, found that the government using PBMs saved Medicare Part D 20 percent (over $30 billion) in just one year. Similarly, a 2022 study from the National Bureau of Economic Research’s Casey Mulligan (the former chief economist of President Trump’s Council of Economic Advisers) found that PBMs are worth at least $145 billion beyond their resource costs.

Why, then, are some in Congress and the North Carolina statehouse attempting to regulate them?

Simple: money talks. Last year alone, pharmaceutical and health product manufacturers and their trade associations spent $375 million in lobbying.

Drug companies want to inflate prescription drug prices at will, and they will only be able to do so if politicians help them weaken PBMs, the biggest thorns in their side.

30 percent of North Carolina residents have already stopped taking prescribed medication due to cost concerns. Many of North Carolina's healthcare patients fear that their hospital stays will put their families on the brink of bankruptcy; others return to state hospitals not soon after they are discharged because they rationed their medications.

The lack of affordable healthcare is one of the most significant issues affecting this state and country. North Carolinians recognize it. That’s why 75 percent of them believe it is “very important” or “extremely important” for Congress and the president to address the high price of prescription drugs.

North Carolina’s Senators Ted Budd and Thom Tillis have a reputation of cutting through lobbyists’ noise and getting to the root of what matters most to their constituents. Their opinions matter to their colleagues in Congress and their peers in the North Carolina statehouse. I hope they will lend their voices to this critical discussion. My clients depend on affordable medications, and HB 246 and HR 2816 won’t help them at all.

Laurie Moody
Licensed Counselor working in Western NC
Former Regional Director for Rep. Patrick McHenry