Opinion: Big Pharma just raised drug prices again. 

This year, the drugmakers already hiked the costs of more than 500 prescriptions. Increasing drug prices beyond the inflation rate has become a pattern within the healthcare industry in recent years, and polling indicates it’s a significant concern for over half of Missouri. This is no concern for Big Pharma, however. The drug giants want to profit off Missourians as much as possible. They don’t care that a difficult economy and high inflation have already left them with far emptier pocketbooks; they just want more profits.

Which raises the question: what can Sens. Erich Schmitt, Josh Hawley, and the rest of the Missouri congressional delegation do to mitigate this health crisis?

First and foremost, they should address the collusion and monopoly power that seems to allow the pharmaceutical industry to continue raising their costs without challenge.

The three largest drug wholesalers, which rank as numbers three, four, and five on the Fortune 500 list, respectively, own the vast majority of the cooperative pharmacy networks that help to set drug prices in the United States. In fact, according to the Pharmaceutical Care Management Association, an estimated 75 percent of independent and small chain pharmacies maintain contracts with the networks owned by the Big Three wholesalers. This appears to be a clear conflict of interest, and it may be costing the American people dearly.

One of these three companies, Cardinal Health, even had to pay $8 million to the government to resolve allegations that it paid kickbacks to pharmacy owners for referrals. According to the then U.S. Attorney for the Western District of Missouri, who led the investigation, “American taxpayers are the victims of illegal kickback schemes that result in Medicare and Medicaid paying millions of dollars more than they should for prescription drugs.”

At a minimum, the marketplace power that these three drug wholesalers have amassed demonstrates the signs of being a potential antitrust concern, and this matter deserves the Missouri congressional delegation’s scrutiny.

Addressing marketplace concentration issues normally takes a considerably long time, but that’s not to say that there’s nothing Missouri’s lawmakers can do in the interim to mitigate the problems that may be occurring from these companies’ potential collusion.

One thing our politicians can do quickly is allow Missouri residents to buy prescription drugs from other countries, like Canada. The big drugmakers sell their products at significantly reduced costs to our northern neighbors because they impose price ceilings on healthcare products.

Last month, Florida became the first state to offer drug importation from Canada after getting approval from the FDA. There’s no reason Missouri shouldn’t follow this example.

Our politicians should also ensure the state government makes greater use of pharmacy benefit managers (PBMs) in public workers’ health plans. These third-party entities are paid to negotiate with the drug companies. They have the power and leverage to make the drug giants lower their prices so ordinary Americans can afford the medicines they need.

97 percent of the millions who contract with PBMs directly are very happy with their services. It’s easy to understand why — they have a track record of reducing prescription drug prices.

The U.S. Government Accountability Office has conducted multiple studies on PBMs, finding that the drug price rebates PBMs mediated “offset [Medicare] Part D spending by 20 percent, from $145 billion to $116 billion.” Non-governmental organizations have also found similar results. For example, in 2022, The National Bureau of Economic Research conducted a survey on PBMs and found that the service manages to bring in $148 billion in savings for healthcare recipients every year. Given the impeccable results that PBMs have in fending off Big Pharma’s abuses, it is clear that the government should use PBMs whenever possible when purchasing healthcare for public workers.

Big Pharma thinks that members of Congress and the state legislature — which receive hefty campaign contributions from the drugmakers —  would never do anything to stop their anti-competitive, anti-consumer pricing. It’s time for the Missouri delegation to prove them wrong. Their constituents are suffering tremendously from how expensive life-saving medications are today. This problem has gone on for long enough. It’s time for change.