For more than a decade, I’ve helped everyone from local shops to large employers navigate one of the most frustrating markets in the country: healthcare. Rising medical and pharmacy costs have chipped away at household budgets and business margins alike. My work has always centered on shielding employees and families from premiums and expenses that seem to climb every year without relief.
In that time, I’ve seen plenty of new ideas and “disruptors” promise to fix everything. Some help, some don’t. But one principle always proves true: you make progress when incentives align and the rules of the game are clear. That’s where pharmacy benefit managers — PBMs — still play an important role, even if they’ve become lightning rods in today’s debate.
PBMs are often criticized, sometimes fairly so. Parts of the industry have contributed to confusion, and reform is warranted where misaligned incentives exist. But modern PBMs also emerged for a reason: employers need help managing a complicated drug market that includes manufacturers, wholesalers, pharmacies, and ever-shifting prices. Without someone negotiating on their behalf, especially small and mid-sized businesses, many would simply be price-takers in a system they have no ability to influence.
Prescription drug costs continue rising, and access challenges persist. Kansans are feeling it at the pharmacy counter just as they are at the grocery store and with childcare expenses. The conversation we should be having is how to encourage greater transparency, smarter plan design, and fair negotiation — not how to remove tools that help employers push back on rising prices.
Regulators have an important role to play, but the balance matters. Policies that are too rigid or overly prescriptive may unintentionally weaken employers’ negotiating power or limit the strategies that keep coverage affordable. Kansas can look to other states like Arkansas as an example of how well-intended but heavy-handed rules sometimes create more problems than they solve.
Senior Vice President, Christensen Group Insurance
