Protect NC consumers from higher medication costs

It’s hard to put a price on one’s health and well-being, but nowadays, accelerating health care costs are making it increasingly difficult for working families to make ends meet. A recent Gallup survey highlighted that most Americans struggle to afford primary health care, with the percentage of “cost-secure” U.S. adults reaching historic lows.

This cost insecurity is particularly evident in the price of prescription drugs. Americans pay more for medications than citizens of any other developed country, with some lifesaving drugs costing several hundred or even thousands of dollars. These expenses strain household budgets and force many to choose between their health and other essential needs.

North Carolina residents are acutely aware of these growing concerns. Almost 3 in 5 North Carolinians worry that medication costs will remain unaffordable. Thankfully, members of our state legislature are working to address these concerns and proposing potential solutions.

A crucial tool for keeping medical costs down is the role pharmacy benefit managers play behind the scenes in negotiating payment agreements among insurers, drugmakers and pharmacies. Legislation pending in the N.C. General Assembly , House Bill 246, would weaken PBMs’ negotiating authority, reduce pharmacy competition, curtail bulk discounts and push prescription drug prices higher for consumers. That’s bad medicine for North Carolina.

PBMs promote significant cost savings for patients with chronic illnesses who rely on medications they must be able to afford. Without PBMs, the chronically ill could pay over $1,000 more each year.

PBMs also play a crucial role in managing lists of covered medications, ensuring that patients can access a comprehensive range of affordable and effective treatments. By promoting generic drugs and other cost-effective alternatives, PBMs help keep health care costs in check. They also provide valuable clinical services such as medication therapy management, which helps patients stick to their treatment plans and avoid costly complications.

Patients and businesses rely on PBMs to manage employees’ health care and secure savings. Large and small employers use PBMs to design and administer their prescription drug benefits, which helps them keep costs under control and provide comprehensive health coverage to their employees. PBMs contribute to employer-sponsored health plans’ overall affordability and sustainability by negotiating better prices and ensuring the efficient use of medications.

The PBM restrictions proposed in HB 246 would undermine these significant benefits by suppressing competition and innovation. They would add red tape, raise costs and hamper our health care system instead of helping it. Instead of crippling PBMs, state lawmakers should acknowledge and build on their cost-effective foundation.

At a time when inflation remains high, North Carolina residents and businesses need all the cost savings they can get. Rising prices are affecting every aspect of life, from groceries to gas, making it more critical than ever before to keep health care expenses manageable. PBMs help alleviate some of that financial pressure and bring us closer to the goal of accessible and affordable health care for all.

Although the intentions behind HB 246 and other proposals like it might be well-meaning, their anti-PBM measures could backfire, harming patients by increasing medical costs and reducing health care access.

Our legislators in Raleigh should consider carefully the long-term consequences of HB 246 and prioritize the well-being of their constituents by ensuring that PBMs can continue to provide vital cost-saving benefits in our complex health care system.

The first rule of lawmaking, like that of medicine, should be: Do no harm.

Mike McCaskill is the owner of Fayetteville’s Prestige Properties.

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