PhRMA launches new ad calling for Congress to make sure savings go to patients, not PBMs

Today, PhRMA launched new advertisements urging Congress to make sure savings on medicines go to patients, not middlemen. The ad highlights how middlemen, like pharmacy benefit managers (PBMs) and insurers, use medicines as a profit center while driving up costs for patients and the health care system.

PBMs and insurers get billions in rebates and discounts on medicines, yet they often refuse to pass these savings on to patients at the pharmacy counter. Rebates can lower the average price that PBMs and insurers pay for medicines by more than 50%, but patients rarely benefit directly from these savings. Patients shouldn't pay more for their medicine than PBMs and insurers. Instead, PBMs should share these savings on medicines directly with patients and help lower their out-of-pocket costs.

The new advertisements come amidst growing scrutiny, investigations, and lawsuits against PBMs from bipartisan stakeholders nationwide, including federal agencies, state Attorneys General, Congress and the media.

• For instance, the New York Times uncovered that PBMs "steer patients toward pricier drugs, charge steep markups, and collect billions in hidden fees." High-cost drugs often mean larger fees that PBMs usually keep, potentially increasing patients' out-of-pocket costs.
• The Federal Trade Commission (FTC) found similar examples of PBMs' patient-harming practices, including one PBM executive confirming the three largest PBMs steer patients towards higher-list price medicines rather than lower-cost alternatives so they can "drink down the tasty… rebates."
• New data also shows that as patients pay more for their medicines out-of-pocket, PBMs and insurers benefit from rebates and discounts that lower their prices for those same medicines.
• And a new survey found that more than nine in 10 Americans want insurers and PBMs to pass these savings on directly to patients at the pharmacy counter.

The new advertisements build on previous efforts to highlight the growing problem that PBMs and health insurers are owned by the same massive health care conglomerates and are further consolidating their control over the health care system, allowing them to extract more profits at the expense of patients. In fact, over half of every dollar spent on medicines goes to PBMs, insurers and others who do not research, develop, and manufacture the medicines.

The Time for Congress to Act Is Now

As Congress returns for the final legislative session, they have an opportunity to pass PBM reform that will make medicines more affordable and accessible for patients. In Congress, both chambers have made progress on PBM reforms including on rebate pass through, PBM transparency, and delinking PBM payments from list price. Our campaign adds to the growing chorus of voices, including pharmacies, providers, employers, AARP and others, calling on policymakers to help patients by pushing these critical PBM reforms over the finish line.

It's time for Congress to make sure savings go directly to patients, not middlemen.