As the Executive Director of Advocates for Responsible Care (ARxC), a non-profit advocacy organization, we work with our partners to expand affordable and equitable access to health care in Georgia. As a 40-year Nurse Specialist whose focus is the voice of patients, we are advocates who walk the walk and live the life of people challenged by chronic illness. ARxC has led the Rx in Reach GA Coalition, consisting of members from 42 health-centered organizations (see below) representing physicians, nurses, patients and community organizations, advocating for polices and legislation that ends financial and discriminatory barriers to securing vital medical care, treatments and medications.
We are urgently lending our support for H.R. 2880, sponsored by Congressman Buddy Carter. This legislation will curb PBM’s dangerous polices. For too long, pharmacy benefit managers, PBMs, have operated largely without regulation, transparency, or accountability, and their shadowy, money-milking ways involve restricting patient access to prescription drugs while imposing exorbitant costs.
There are too many “hidden” players in the quest for patients to get affordable access to prescription drugs and vital treatments. For years, health insurance companies and PBMs have negotiated significant rebates and discounts for the cost of medicines however, do not pass these savings along to patients. Patients shouldn’t pay full price for drugs sold to insurers and PBMs at deep discounts.
Patients are subject to PBM practices that are driving up the cost of prescription drugs desperately needed by Georgians. As health advocates, we hear the voice of patients everyday who battle serious chronic and terminal illness, and who must also battle their insurer’s PBMs. PBMs are compensating their own pharmacies over network pharmacies. They are operating without transparency of their administrative and rebate amounts that they are taking instead of passing the discounts to patients for whom rebates were intended. PBMS have long dismissed conflict of interest to Part D plan’s pharmacy and therapeutics committee.
Patients need real solutions to the PBM middlemen profiteers. The interests of patients should come first when it comes to access to their medicines. H.R. 2280 will:
Require full disclosure of the financial incentives PBMs receive – like aggregate rebates, administrative fees, and other payments.
Address the outrageous PBM profits of the rebate system. Requiring PBMs and health plans to share the savings they receive on medicines directly with patients at the pharmacy counter would lower patient out-of-pocket costs. Rebates directly to patients could help Georgians save up to $1,000 annually on life-saving medicines.
Prohibit spread pricing. Save money by ensuring health plans, employers and government programs are getting the best deal possible and not being charged more for medicines than PBMs cost.
This oversight legislation of PBMs is long past due to end penalizing patients and allow them to receive their drugs that keep them active, working, reducing their disease flares and improving their quality of life; which always results in better health outcomes and reducing our health system expenses. We ask Congress to pass HR2880 quickly to help patients receive the medications and treatments they vitally need.
Patient’s Bottom line: We’ll have a better, more equitable and affordable prescription market when we reign in the middlemen profiteers and leave the practice of medicine to the medical professionals.
We thank you for your service to Georgians and your attention to future health policies that improve their lives.
Dorothy and ARxC/Rx in Reach Georgia Coalition
Dorothy Leone-Glasser, RN, HHC
Executive Director, Advocates for Responsible Care (ARxC)
Project Lead, Rx in Reach GA Coalition
Chair, Center for Global Health Innovation (GA Bio) Patient Advocacy Alliance
404-633-5843 - office
678-778-3614 - cell
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