It is hard enough to manage the high out-of-pocket expenses that come with the prescription medications I rely on without having to worry about greedy insurers and Pharmacy Benefit Managers using every trick in the book to boost their profits at the expense of patient access and affordability. That is why Congress must work to pass legislation to reform and rein in harmful PBM practices—and that must happen this year. 

PBMs are the healthcare middlemen that control roughly 80% of the prescriptions on the market today. Sadly, they use a range of business practices—including prior authorization and pharmacy “steering”—to dictate exactly when and where patients can access the critical medications and treatments they need to stay healthy. Even worse, PBMs will actually withhold vital drug discounts and rebates to inflate their profit margins instead of passing those savings down to patients to help reduce out-of-pocket costs. 

This is one of the most pressing issues for millions of patients in North Carolina and across the country, and it’s certainly been on lawmakers’ radar this year, with multiple versions of PBM reform introduced in both the House and the Senate. For the good of their constituents, Senators Budd and Tillis should work to support and help pass both the Delinking Revenue from Unfair Gouging (DRUG) Act as well as the Modernizing and Ensuring PBM Accountability Act without delay. Patients like me literally cannot afford Congress to kick the can down the road on this issue any longer.

Anna Shoemaker
Kernersville, NC