Thanks, Roger Marshall, for focusing on middlemen’s influence over high drug prices | Opinion

At The Whole Person, we strive to serve people with disabilities by connecting them to the resources they need and supporting their ability to make their own choices. For those that need regular access to medications, finding ways to bring down costs without hurting that access is critical.

An important but not well-understood part of the pharmacy supply chain are go-betweens known as pharmacy benefit managers or PBMs. While not well known by the average patient, these third-party companies wield immense influence over which drugs are covered by insurance, how much patients will have to pay out-of-pocket for those drugs, and even which pharmacies patients can fill their prescriptions. These companies negotiate drug prices with pharmaceutical companies and pharmacies, ostensibly for the benefit of insurers, employers that provide health insurance, Medicare Part D drug plans and others who pay for health care coverage. However, because they receive manufacturer rebates tied to the cost of the medications they deal with, PBMs may have incentives to favor higher-priced drugs over similarly effective, cheaper alternatives.

In 2022, the Kansas Legislature took a critical first step by requiring PBMs to be licensed by the state to continue operating here. This is a significant first step toward lowering prescription drug costs and protecting access to those medications.

We would like to see our elected officials go even further in regulating the most egregious practices of PBMs. And we are pleased to see U.S. Sen. Roger Marshall doing just that. Marshall has consistently advocated that PBMs share the rebates and discounts they negotiate on drug prices with Kansas patients. He has also asked community health clinics about their concerns, and specifically about how PBMs pocket the savings meant for safety net health care providers. Marshall supports repealing anticompetitive carve-outs for these third-party companies, which would benefit patient access and choice.

The consolidation and subsequent increased influence that PBMs have accumulated over time have hurt patients through opaque business practices, higher profit margins and limited pharmacy choices for consumers. Many PBMs operate their own pharmacies and require their customers to fill prescriptions there, even if they are inconvenient for the patient. For disabled Kansans, travel can already be a barrier. Limiting their choice in anything — especially something as critical as medication — only adds complexity to their day.

Patients, not a corporate middleman, should have the right to choose their most trusted provider. In rural Kansas, independent pharmacies have been especially hard hit by pharmacy benefit managers’ practices. Whole communities could lose access to their trusted local pharmacists due to ongoing and aggressive market consolidation by PBMs.

Kansas patients deserve better, and we are lucky to have Sen. Marshall fighting for us.