ROCHESTER, N.Y. — Most can agree that prescription drug costs in the United States are high. What folks can’t agree on is what the solution to that problem looks like.
For example, our Deanna Dewberry and her husband and kids take prescription medication. When she went to pickup an over-the-counter drug and four prescriptions, her total came to $84.31.
What’s the solution?
“Look, the high cost of prescription drugs is at the center of our affordability crisis right now,” said former U.S. Representative Jim Cunningham. “And voters are gonna make their voices heard.”
Former representative Cunningham, a Democrat, and JD Hayworth, a Republican, are on opposite sides of the political aisle. But the two agree on this.
“Reigning in the greed of big pharma is by far the top priority and codifying most favorite nation is at the top of that list,” said Cunningham.
“And the poll numbers are incredible. this is one issue where there’s great unanimity,” said Hayworth.
According to the U.S. Department of Health and Human Services, American pay about three times more for prescription drugs than other wealthy nations.
Most Favored Nation (MFN) pricing would cap the cost the U.S. pays for brand name drugs at the lowest price other developed nations pay.
The “real driver” of costs
While the public may agree, policy analysts do not. A Harvard article says “MFN pricing is a shortcut masquerading as a solution.” The article points to middle men known as Pharmacy Benefit Managers as the real drivers of inflated drug costs.
READ MORE: Harvard’s article on MFN pricing as a solution to prescription drug costs
The PBM is a middle man with a big role in controlling what you pay and what your pharmacist gets paid. The PBM develops a list of the medications your insurer will cover, negotiates rebates and discounts, and pays pharmacies for the drugs you buy.
PBM controversy
The role is controversial. Why?
Let’s say your pharmaceutical company charges $1 per pill for a drug. The PBM negotiates a rebate of 50c. The PBM keeps a portion of that rebate. Let’s say 20c for itself, and then passes the rest (30c) to your insurer.
READ MORE: Federal Trade Commission’s article on PBMs
Consumer Alert: ‘Most Favored Nation’ pricing could lower brand-name drug costs, but analysts question the idea WHEC.com.
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