For people living with chronic and complex illnesses, consistent treatment access is critical to stay healthy. However, burdensome practices from insurance industry middlemen are creating unnecessary barriers to care for patients and providers alike.
Louisiana state legislators must act now to reform a growing industry of pharmacy middlemen, known as pharmacy benefit managers (PBMs), who are driving up the cost of care in the Bayou State.
Louisiana has consistently ranked amongst the least healthy states in the nation. Despite a high prevalence of chronic illnesses, Louisiana ranks second for the most expensive health care in the country. While patients struggle to manage high health care costs, PBMs continue to block medication access by driving up prices.
Hired by insurance companies, PBMs work between insurers and drug manufacturers to negotiate discounts on medications on behalf of the health plans they represent. However, they are not required to be transparent about the rebates they receive or pass those discounts on to patients at the pharmacy counter.
Louisiana has an opportunity to hold PBMs accountable and ensure that patients benefit from manufacturer savings. Senate Bill 347 would require insurers and PBMs to share negotiated discounts and rebates at the pharmacy counter. If passed, the bill could save some patients nearly $1,000 every year.
When a patient’s out-of-pocket costs become too high to manage, they become more likely to abandon their treatment plan, which can lead future emergency room visits, additional medical complications and even higher health costs for the individual patient, as well as the overall health system. To improve health outcomes in Louisiana, the state Legislature must support SB 347 to alleviate health care access and affordability burdens that persist for patients across the state.
KATHY OUBRE
chief executive officer, Pontchartrain Cancer Center in Covington