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Opinion: A Conservative Free Market Approach to Health Care for Missourians

Over thirty years ago, the 340B drug pricing program was established with the noble intention of assisting safety-net hospitals and clinics in providing affordable medications to low-income and vulnerable patients. Over the years, it has fulfilled this purpose admirably, ensuring that those in need have access to vital medications at discounted rates.  This initiative has been a lifeline for countless individuals, delivering on its mission to serve the disadvantaged.

The core strength of the program lies in its flexibility and responsiveness to the needs of underserved communities. By allowing hospitals and clinics to purchase medications at discounted rates, it empowers them to reinvest savings into critical services and expand access to care for vulnerable populations. This not only benefits patients directly but also strengthens the health care infrastructure in underserved areas.

Additionally, the involvement of pharmacies in the 340B program has enhanced its reach and effectiveness. Contract pharmacies play a crucial role in extending the benefits of the program to remote and underserved communities, ensuring that patients in these areas have access to affordable medications.

Pharmacy benefit managers (PBMs) play a vital role in negotiating lower drug prices on behalf of consumers and insurers. Their ability to leverage economies of scale ensures that medications remain affordable for all, regardless of the size of the pharmacy or health care provider.

Efforts to reform the current PBM program, such as HB 1627, are unnecessary and misguided. Rather than promoting competition, these reforms risk destabilizing the healthcare supply chain and undermining the affordability of medications for millions of Americans. The purported benefits of increased competition pale in comparison to the real-world consequences of disrupting a system that is working effectively for the vast majority of patients.

Large employers, businesses, labor unions and school districts oppose HB 1627 out of legitimate concerns for the well-being of their employees and members. Exclusive contracts with large PBMs ensure stability and predictability in health care costs, allowing private businesses and unions to negotiate comprehensive health benefits for their employees and members. Any attempt to undermine these contracts threatens to erode the hard-won gains.

The 340B program and PBM arrangements represent essential components of a health care system that prioritizes access and affordability for all. Rather than succumbing to misguided calls for reform, we should celebrate the successes of these programs and work to strengthen and expand their reach. It’s time to put the needs of patients ahead of political agendas and embrace policies that ensure access to affordable medications for all Americans.