Pharmacy benefit managers help Missourians afford their prescriptions | Opinion

Prescription drugs are unaffordable for too many Americans. Whether you’re a patient managing a chronic condition or a policymaker looking for sustainable reforms, everyone wants to find pragmatic, long-term solutions to lowering the cost of life-saving medication.

If we’re serious about making prescription medication more affordable, we need to use every tool available. One of the most effective tools we already have is pharmacy benefit managers, or PBMs.

PBMs negotiate directly with drug manufacturers to lower the prices patients pay for their medications. PBMs are hired by employers, health plans, unions and public programs such as Medicaid to secure discounts that individual patients could never get on their own.

The results are staggering. PBMs can reduce prescription drug and related medical costs by 40% to 50%. Every dollar spent on PBM services results in $10 savings on health care costs. These savings add up fast. On average, PBMs reduce drug costs by $1,040 per patient per year. These savings help families afford the medications they need while also protecting small businesses and public programs from runaway health costs.

Take insulin, for example. PBMs were first to negotiate lower out-of-pocket costs for insulin on eligible plans — as low as $25 per month. That’s real savings going back into the pockets of patients who need it most.

To most Missourians, the role of a pharmacy benefit manager is common sense. A recent survey found that 9 in 10 voters want insurers to work with PBMs to negotiate lower prescription drug costs, and 81% are concerned about efforts to limit that role.

Because too often in our lives, no one has our backs — and even more so when it comes to the high cost of everyday living. That’s why PBMs exist, but also why consumers appreciate the role they play, especially once they learn more about them. PBMs provide negotiating power. They are the only force in the health care industry that has a 360 degree view of a patient’s health while also having the ability to negotiate lower costs. That negotiating power brings down the cost of prescription drugs, leading to spending power for consumers. PBMs also improve things such as drug adherence, which promotes better health outcomes.

PBMs are working every day on behalf of more than four million Missourians. Voters overwhelmingly support PBMs and recognize their essential role in driving down drug prices. They don’t want to see that impact diminished.

Our nonprofit, Prescription Benefits Matter, is working to make sure people understand how PBMs help lower drug costs. In today’s complex health care environment, patients deserve transparency. That starts with telling the full story of how PBMs keep prescription costs under control. Patients also deserve the ability to afford not just their medications, but their grocery bills, housing costs and other essential elements of daily life.

At the end of the day, most people don’t care about industry acronyms. They care about whether they can afford their prescriptions. PBMs help make that possible.