Tuesday, June 18, 2024

Support for bipartisan bill addressing lowering copays

| May 3, 2023 1:00 AM

As a nurse working with pediatric patients, I’ve seen how difficult it can be for families struggling to meet the health care needs of their children. I’ve also unfortunately witnessed firsthand how the policies and practices put into place by pharmacy benefit managers (PBMs) can adversely impact patients and their families as well as health care providers.

PBMs are the middlemen between drug manufacturers and insurance companies. Controlling over 80% of the prescription drugs available on the market today, they play a huge role in determining a drug’s accessibility. While they’re supposed to negotiate rebates to help lower out-of-pocket costs, PBMs are more likely to keep these savings in order to boost their own profits rather than passing them down to patients and families.

Not only that, but the overly cumbersome, convoluted prior authorization processes put in place by PBMs can create major delays in patients accessing the treatments they need. The obstacles and delays caused by PBMs’ prior authorization policies can worsen patient outcomes and create undue stress for patients and families alike.

Fortunately, some lawmakers in Congress have noticed the growing problem PBMs pose for patients and have introduced bipartisan legislation called the Help Ensure Lower Patient (HELP) Copays Act. Our elected officials in Washington should help support efforts in Congress to rein in the unfair practices PBMs use to profit off the pain and expense of everyday Montanans.

Haley Leun, Kalispell