Originally appeared on the news website Delaware Online
Michael Beals and Robert Hall
Special to the USA TODAY Network
It’s understandable to wonder why a rabbi and a reverend would be offering editorial commentary on an issue as seemingly secular as prescription drug pricing and the medication supply chain. It is because what would seem on the surface to be strictly a public policy issue has become nothing less than a systemic moral failure, one that is doing serious harm to people in our congregations, across Delaware, and the entire country.
We have joined other members of the clergy in our state in a letter to U.S. Senator Chris Coons, urging him and his colleagues to act expeditiously in passing reform legislation to stop the current practices of pharmacy benefit managers, or PBMs. PBMs are corporations that determine whether patients can access their medications and how much they pay for those medications when they fill a prescription at the pharmacy. Every day in our communities, we are seeing the impact of what the PBMs are doing in the form of people losing jobs and patients being unable to afford the medicines they need.
Congressional committees, the Federal Trade Commission and multiple journalists have compiled volumes of information on how the PBMs, essentially middlemen in the supply chain, are manipulating the drug pricing process for their own profit. The six largest PBMs control 95% of the prescription drug marketplace and they are combining with health insurers, mail-order and specialty pharmacies and health care providers to form mammoth multinational corporations and a competition-free environment.
What they are doing with this power is unconscionable. They are demanding large rebates and discounts from drug manufacturers, keeping those dollars instead of passing them along to patients, and then the PBMs are steering patients toward higher-priced drugs that generate the greatest profits for them. They are charging employers and governments far higher prices to acquire drugs than they are paying the pharmacies that dispense them and, in fact, a report issued last month described how a major PBM overcharged postal workers $45 million for medicines over five years. Their price manipulations are sometime difficult to believe. One recent study found that PBMs were charging over $4,400 for a multiple sclerosis treatment that could be purchased at Mark Cuban’s Cost Plus Drug company for less than twenty bucks.
For so many Delaware households, the impact of these practices has been devastating. In the past year alone, multiple pharmacies in the state have closed in no small part because PBMs reimburse them less to dispense medicines than it costs the drugstores to purchase them. Further, PBMs are encouraging customers to use their own mail order and specialty pharmacies, pulling business away from community pharmacies. This is costing people their jobs and leaving too many neighborhoods without what had been a trusted health care center.
And, as the Federal Trade Commission pointed out in its report on PBMs, nearly three of every 10 Americans are reporting that they are either rationing their prescriptions or skipping doses of necessary medicines because they can’t afford the out-of-pocket costs that, again, are determined by the PBMs.
There are solutions within easy reach for Congress. In fact, they’ve already been incorporated into legislation. PBM profits should not be connected to the price of medication to remove the incentives to steer patients toward higher-priced drugs. And PBMs should be required to pass cost savings to patients. In both the U.S. Senate and House, there is genuine bipartisan momentum behind these ideas.
We are speaking out on this because this is undeniably a moral issue affecting the health and well-being of our communities and the people to whom we minister. It is simply wrong when anyone has to choose between food and medicine, or when they lose their jobs and wonder how to keep a roof over their heads, all so a small handful of mega-corporations can move a few spots up on the Fortune 500 list.
Congress has the ability to fix what is clearly broken to make medicines affordable and enable neighborhood pharmacies to keep their doors open. In this case, the smart thing to do and the right thing to do are perfectly aligned.
The Rev. Robert Hall serves as pastor of Salem United Methodist Church. Rev. Hall recently retired as executive director of the Delaware Ecumenical Council on Children and Families. Hall also served as president of the Delaware Public Health Association, vice-president of the Health Education Network of Delaware, and vice-chair of the Delaware Consumer Health Care Coalition.
Rabbi Michael Beals is lead Rabbi at Temple Beth El in Newark, Delaware, chair of the Delaware Council of Faith-Based Partnerships and served twice as oresident of the Delaware Association of Rabbis and Cantors.
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