The following content is Americans who support limited government.
President-elect Donald Trump vowed to take on big pharmacy benefit managers (PBMs) during a press conference Monday at Mar-a-Lago.
“Frankly, these are horrible middlemen who make more money than the drug companies. They don't do anything but be middlemen. We're going to knock the middlemen down,” Trump said.
He explained that eliminating BPM would “lower drug costs to levels that no one has ever seen before.”
President Trump noted that Health and Human Services nominee Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services nominee Dr. Mehmet Oz had discussed PBM reform extensively. All the executives and Oz. We spent more time talking about that than anything else. ”
One of the biggest reasons for high prescription prices is the PBMs of major insurance companies. Three giant PBM intermediaries, CVS Caremark, Express Scripts, and OptumRx, control approximately 80 percent of the total PBM market and administer drug benefits for more than 270 million Americans.
PBMs inflate profits by pushing out more expensive drugs when designing formularies and lists of drugs available to customers. By setting favorable prices and co-payments, PBMs essentially determine how much patients will pay out-of-pocket and what medicines are available to them. If a drug is not on your prescription, your insurance company will not cover it. And in many cases, doctors won't prescribe it even if patients need it.
Kevin Duane, a pharmacist from Jacksonville, Florida, recently told the House Oversight and Accountability Committee: Because, for better or worse, PBMs can benefit more from it. ”
Essentially, PBMs are incentivized to prescribe more expensive drugs. This is a broken system that President Trump has long begun to repair. In 2020, President Trump introduced a policy that would allow seniors to directly benefit from rebates that drug manufacturers pay to PBMs for preferential listing on insurers' drug formularies. These rebates were intended to reduce the cost of expensive medicines for seniors. President Trump laid out a detailed plan to extend these savings to seniors and potentially save billions of dollars.
“That means patients will benefit, not very wealthy people,” Trump said at the time. “Today's action ends this inequity and demands that these discounts go directly to the people who need them.”
Unfortunately, Joe Biden's so-called Inflation Control Act repealed President Trump's drug rebate rules, leaving the most at-risk seniors unable to get the savings they need.
Mr. Trump and his medical team will no doubt reinstate the Trump rebate rule and huge savings for seniors.
More than 20 conservative groups recently encouraged Congress to pass the PBM Accountability Modernization and Securing Act (S. 2973) and the Mental Health, Low-Cost Drugs and Bulking Agents Package (S. 3430). These bills would reset the money-making incentive to benefit patients by decoupling PBM fees from drug prices. Decoupling drug prices from fees charged by PBMs would help fix the incentives in the system that drive up drug costs for seniors and PBM profits.
Eliminate the PBM middleman, fix the corrupt system, and deliver savings to older Americans. That would be a great start for President Trump's health care policy.
