I have spent my career fighting for the hardworking people of our state—especially those who need our support the most. Now, as Congress reconvenes to address critical issues affecting Americans, ensuring affordable health care must be a top priority. Missourians, especially our seniors, face mounting challenges from rising prescription drug prices that are putting lifesaving medications out of reach. But unfortunately, certain legislative proposals threaten to make this situation even worse, resulting in higher premiums for seniors and shifting costs onto taxpayers.
One of the main proposals we are seeing pushed by Congress, is actually fueled by Big Pharma and their greed, and aims to destroy an essential piece of the health care system, and only check against drug companies: pharmacy benefit managers (PBMs). The proposed policy, “delinking” would single-handedly destroy market-based incentives that PBMs utilize to better negotiate essential rebates and discounts from drug manufacturers.
If Pharma had its way, the American people would face devastating circumstances, with Medicare Part D premiums soaring by billions of dollars, all while Big Pharma pockets billions more.
According to University of Chicago Professor Casey Mulligan, Ph.D., if “delinking” were implemented, it would lead to an increase of $13 billion in premiums for seniors, while creating an $11 billion financial windfall for drug companies. Dr. Mulligan explains:
“Incentives matter for PBMs just as they do for other market participants. A financial reward for greater rebates and discounts results in greater rebates and discounts. Conversely, eliminating pay for PBM performance would reduce PBM performance.”
Our seniors certainly cannot grapple with these increased costs.
Put simply, without the current market-based incentives, PBMs would have fewer tools to negotiate significant rebates and discounts from Big Pharma. This change would mean higher costs for plans, fewer savings for seniors and billions of dollars of revenue for drug companies.
While the left and Big Pharma join forces to paint PBMs as the enemy, it is important to affirm the facts. Pharmacy benefit companies are an essential element of the free-market health care system, using their power to negotiate lower prices for patients and our seniors. Through their work, PBMs save Americans $148 billion a year – totaling $1,040 per person annually. PBMs have an important role in the health care ecosystem, and ill-intentioned policies like “delinking” aim to disrupt this delicate balance.
The stakes are high. This lame-duck session is Big Pharma’s chance to push delinking through under the radar, making it urgent for lawmakers to resist including it in any end-of-year spending packages. For the sake of Missouri’s seniors and all Americans relying on Medicare Part D, Congress must focus on policies that hold drug companies accountable, not reward them.
I have dedicated my life to protecting the well-being of Missourians. I know the best way to keep costs down for seniors is to ensure that PBMs can continue to operate with the incentives that enable them to negotiate effectively with drug manufacturers. Removing these incentives would only weaken competition in the marketplace and increase financial burdens on seniors and taxpayers alike.
Let’s keep our priorities straight. Any end-of-year package should focus on the needs of American seniors and taxpayers, not on boosting profits for Big Pharma. Missouri’s seniors are counting on us to stand firm against Big Pharma’s latest attempt to raise costs. Congress must reject “delinking” and protect the integrity of Medicare Part D to help our seniors.
Represents District 3 in the Missouri Senate
