Money or medicine? Our state’s most vulnerable shouldn’t have to choose
As insurance companies and PBMs rake in rebates that consumers could benefit from, the NAACP Salt Lake Branch is fighting to lower the cost of prescription drugs.
One of the most heartbreaking choices a person can be forced to make is whether or not they can afford their medication. All too often, this life-or-death choice happens in silence: at a kitchen table or after the kids have gone to bed; staring at the black-and-white numbers on a bill; or all alone in a nursing home.
Everyone has not had to make those choices. But those that have know what it’s like to stare into the mirror and think about the value of a human life, our own mortality, and what’s truly important.
Today, the Utah Legislature has a choice to make, as well. It gets to choose whether or not to save patients hundreds of dollars per year, improve convenience, save taxpayers money and most importantly, protect our most vulnerable — including communities of color — from having to pick between medicine and money.
It’s a simple solution, but it takes courage from our lawmakers.
Today, prescription drug manufacturers pay billions to health insurers and pharmacy benefit managers, or PBMs, in the form of rebates in order to get preferential treatment on insurers’ drug plans. These rebate payments are supposed to drive the cost down for patients, but instead go towards health insurers’ and PBMs’ bottom lines. This year, the Utah Legislature considered changing this practice but didn’t eventually advance a solution. Now is the time to ensure that billions of dollars in rebates get passed directly to consumers at the pharmacy counter.
The NAACP Salt Lake Branch is fighting for this change because communities of color across Utah struggle to afford the cost of health care, including prescription drugs.
“In this scenario, patients are more likely to stick to the program prescribed by their doctor, rather than the one prescribed by their budget.” — Jeanetta Williams
It is estimated that as much as $106 billion in rebates was given to health insurers, PBMs and the government in 2015. Right now, these rebates provide a perverse incentive in the market, and ending this practice will directly provide patients in Utah real savings. Providing the discount at the point of sale, to the customer, is the solution our lawmakers need to focus on.
There’s an additional benefit as well: the Congressional Budget Office estimated that providing discounts at the point of sale will lead to $20 billion in savings in Medicare Part A and Part B. For every dollar spent, the taxpayers would save two as a direct result of better health outcomes.
Most simply, individual patients would save hundreds of dollars per year in out-of-pocket costs. In this scenario, patients are more likely to stick to the program prescribed by their doctor, rather than the one prescribed by their budget.
And maybe, just maybe, it would mean fewer choices for all of us between life, or poverty, or death.
Jeanetta Williams serves as the president of the NAACP Salt Lake Branch and of the NAACP Tri-State Conference of Idaho, Nevada and Utah. She is a former member of the NAACP National Board of Directors.