Pharmacy benefit managers aren’t the health care bad guys. Thanks to these Missouri officials | Opinion

Every time Missourians shop at a wholesaler, such as Costco or Sam’s Club, they save as much as 30% to 40% over what they would have spent at a grocery store. The reason is simple: Buying in bulk lowers prices and has perks. Why, then, are members of Congress working with the nation’s largest drug companies to stop us from doing the same thing when we purchase prescription drugs?

Most Missourians’ health plans secure bulk pricing discounts using pharmacy benefit managers, or PBMs. Because these third-party companies represent so many health plans, they easily secure discounts from the major drug companies and prevent them from raising prices. The major drug companies know they can’t afford to lose the PBMs’ business, so they begrudgingly agree to provide them with pricing discounts that benefit us all. One estimate shows that PBMs will save this state nearly $20 billion over the next 10 years, while a 2019 Government Accountability Office study found that in 2016 alone, they saved Medicare Part D $29 billion, or 20%.

That’s what makes Congress’ desire to regulate pharmacy benefit managers before the end of the year so puzzling. Members are considering doing so by passing a bill called the PBM Transparency Act, which arose because of the drug industry’s claims that pharmacy benefit managers take excessive monetary cuts for themselves, ultimately increasing prescription drug costs. However, this is not true. Recent data from the Pharmaceutical Care Management Association, a trade association that represents the 11 largest PBMs in the country, shows only 6% of every dollar spent on prescription drugs goes to PBMs, while an alarming 65% goes to the pharmaceutical companies themselves.

If anything needs more regulation, it’s the drug companies, not the Costcos of the health care industry that receive bulk pricing discounts for the American people. Unfortunately, as the old saying goes, money talks — and members of Congress listen.

It seems like more than a coincidence that the drug industry, which showers politicians with campaign contributions, has succeeded in getting some of them to introduce a bill that would make it harder for PBMs to lower their drug costs. But thankfully, many of Missouri’s elected representatives aren’t buying what they’re selling.

One of them is Republican Rep. Eric Burlison, who, as a past board member of the Missouri Consolidated Health Care Plan, has firsthand experience with how effective pharmacy benefit managers are. He told a congressional panel that “we found that using a PBM dramatically drove down our cost for the entire group” and “did save money.” Another one is GOP Sen. Eric Schmitt, who voted against the PBM Transparency Act when it came up for a vote in the Senate Commerce Committee out of a belief that it would increase the government’s control of the health care marketplace.

Congress is expected to push the PBM Transparency Act in the coming weeks and vote on it before the end of the year. But with Burlison and Schmitt leading the charge against the legislation, Missouri can rest easy that the rest of the state’s congressional delegation will heed their concerns and help kill the bill.

Thanks to Missouri, the Costcos of the health care industry will live to see another day, and the drug industry will ultimately be left with nothing to show for the millions of dollars it spent lobbying to shut them down. And for that, we all should be grateful.