Americans want policymakers to see lowering out-of-pocket costs for health care as a top priority. Putting pharma and its innovators who invest billions of dollars in R&D for therapies that improve outcomes and save lives in villainous crosshairs is easy to understand and politically expedient, but misguided.
In 2021, West Virginia became the first state in the nation to adopt ground-breaking legislation, HB2263, requiring insurers and their PBMs to share the savings they negotiate on medicines directly with patients. This legislation serves as a roadmap for other states looking to help lower costs for patients. In the upcoming Georgia legislative session, the state joins that effort with HB 343, most specifically “to require pharmacy benefits managers to calculate defined cost sharing for insureds at the point 4 of sale.”
“People are familiar with the ‘negotiated rate’ they see on a bill from their doctor for a procedure or visit,” Zachary Poss, Director of State Advocacy for PhRMA said. “That reflects a discount compared to published or uninsured rates for those services and procedures. Rebates or discounts pharma provides don’t make their way to patients the way discounts reflected in negotiated rates between insurers, providers and patients do. Those rebates for drugs are held by pharmacy benefits managers. They do not make their way to the patients as they should.”
Making HB 343 law in the State of Georgia would be a strong way to change that.
Dorothy Leone-Glasser (RN, HHC), Executive Director of Advocates for Responsible care encouraged all to, “Become more engaged. What you create saves lives. Pay attention to the legislative alerts. Write an op ed. Support this legislation.”