By Jackie Taylor – Former Cumberland County Republican Party Chair
Families across North Carolina are grappling with the weight of soaring healthcare costs. A recent study highlights this reality, revealing that North Carolina residents face the second-highest insurance premiums anywhere in America, coupled with notable anxiety over rising prescription drug prices. In the face of this urgent crisis, we need legislative action to make healthcare more affordable and accessible. Yet, instead of tackling the root causes of expensive healthcare, our lawmakers in Raleigh are fixated on blaming and targeting a crucial part of the solution: Pharmacy Benefit Managers (PBMs).
PBMs are best known for administering health plans for nearly 275 million Americans – a number that consistently grows each year. They specialize in lowering drug costs by negotiating directly with manufacturers and without them, the cost of medications would skyrocket, imposing an unbearable financial strain and limiting access to essential treatments for countless patients.
PBMs save patients roughly $150 billion a year by securing discounts and rebates on prescription drugs. And, for the average family, this translates into hundreds or even thousands per year in savings. Beyond cost savings, PBMs play a pivotal role in advancing patient care and enhancing medication adherence through programs like specialty pharmacy services. These initiatives empower patients to better understand their medications and achieve improved health outcomes.
They also help bring competition to the marketplace by incentivizing the use of cost-effective medications and promoting the adoption of new, innovative therapies. Patients benefit when major pharmaceutical companies are developing new treatments and providing better outcomes at lower costs.
The main problem with anti-PBM proposals is they would discourage this culture of competition and innovation. To keep our healthcare system thriving, we don’t need more burdensome regulations or red tape.
Consider the ramifications for the nearly 1 million small businesses in North Carolina. Employers have the flexibility to tailor their health plans to their unique needs thanks to PBMs. These businesses don’t want a one-size-fits-all approach or more government control. They want the freedom and choice that comes with a healthcare system powered by the free market.
Some legislative proposals have also proposed mandating a sky-high dispensing fee – one bill even suggesting $10.24 – on most prescriptions in the name of supporting special interest pharmacies. That’s nearly five times the current average dispensing fee paid to pharmacies per prescription. This government handout would increase out-of-pocket costs for patients and hike up premiums for employers. This unnecessary fee will especially hurt those with chronic conditions who rely on drugs the most and could amount to hundreds of additional dollars each year for trips to the pharmacy.
Let’s hope state lawmakers take a more balanced approach and not dismantle one of the few institutions improving healthcare. Patients, employers, and taxpayers are counting on them to pursue more sensible policies. They can start by encouraging greater transparency in drug pricing and demanding greater accountability from drug manufacturers.
North Carolinians cannot afford another costly legislative prescription. Instead of attacking PBMs, let’s recognize the value they bring patients, the money they help us save, and their role in driving positive changes in healthcare.
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