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Why is this insurance middleman so harmful to your treatment access?

Posted by Bobby Brown on December 20, 2023 - 5:44pm


Frustrated by inflated drug costs, tired of jumping through hoops to get medical treatments, your doctor prescribe, you're not alone. Here's the problem on one side, you have drug manufacturers who create medications. On the other, you have insurance companies and patients who pay for these drugs. What you might not realize is there's a middleman called a Pharmacy Benefit manager or PBM in between them, setting drug prices and deciding who gets what treatment based on how much they make, not what's best for patients.

They can even overrule what your doctor prescribes or which medicines your insurance covers. Putting the drugs you need out of reach. Pbs are supposed to help lower costs by negotiating deals with drug manufacturers, but instead of passing down savings to patients, they pocket the money and make enormous profits, which increases the cost to you. The patient PBS operate in the shadows hidden from accountability and transparency, while patients pay the price literally. 


But it doesn't have to be this way. State lawmakers can shine a light on manipulative PBM tactics by requiring them to disclose how much they inflate drug and treatment prices. Pbm should also have to pass down negotiated savings to patients with greater transparency. We can finally lower costs for patients with chronic illnesses and get them the treatments their doctors actually prescribe. Not what makes PBS the most money protect patients, not profits. 

There is A Better Way