Doubling-down on government price setting - as outlined in a recent Bloomberg article - is the wrong approach to lowering patients' costs.

The price-setting provisions of the Inflation Reduction Act (IRA) are still being implemented, yet already seniors are experiencing higher costs, fewer coverage options and more access restrictions. The Biden Administration admits government price setting will encourage insurers to restrict access to medicines by applying utilization management that is not medically appropriate. To consider expanding this program when it's already doing harm is irresponsible.

Government price setting sacrifices access to medicines in an attempt to lower patient costs. But there was no reason for politicians to force patients to make that sacrifice. Meaningful pharmacy benefit manager (PBM) reform will address the real affordability challenges patients experience.

Investigations by the media and state and federal policymakers uncovered how PBMs game the system at the expense of patients, taxpayer and employers. For example, PBMs extract fees and rebates tied to the price of medicines, which experts warn can lead to higher prices. They deny access to generics and other low-cost treatments. PBMs also steer patients to pharmacies they own and then charge steep markups - pocketing the difference.

Just last week, one of these large PBMs agreed to pay at least $45 million to Illinois over claims that the PBM didn't pass through manufacturer rebates to the state over a four-year period. And at the federal level, a new report by the House Committee on Oversight and Accountability summed it up nicely: "PBMs inflate prescription drug costs and interfere with patient care for their own financial benefit."

Only in the United States can middlemen operate unchecked. That's why there's bipartisan support for strong reforms that would rein in PBMs' abusive practices, and most importantly, lead to lower costs for patients at the pharmacy.