The Battle for America’s Prescription Drug System

Prescription drug cost is one of the few issues everyone can agree needs addressing, yet very few politicians seem able to abandon party-line rhetoric to confront the issue. Wealthy corporate campaign donations are now overriding basic common sense when it comes to reining in obvious systemic problems. Like climate change, we see political party leaders making promises, pointing fingers, but ultimately doing nothing. It’s as if no one can get out of their own way to focus on what’s really important — American patients.

It doesn’t help that the prescription drug industry itself seems more concerned with protecting trade secrets than allowing for actual transparency and issue resolution. From protecting formulas to hiding formularies, the prescription drug sector of America’s vertically-integrated oligarchy of a healthcare system is far closer to the steel and railroad monopolies of the early 1900s than an industry model for the 21st century.

Drug prices are high, so pharmacy benefit managers (PBMs) negotiate “rebates” — which are actually kickbacks — to include their drugs on plan formularies. Insurance companies claim they put patients first but maintain lucrative (for them) relationships with the PBMs.

Prescription drug costs are known to be among the highest healthcare spending points for employers. Local doctors, pharmacies, and hospitals are being taken over by PBM/insurance conglomerates, and those who hang their medical shingle as “independently-owned” face higher barriers to entry than in nearly any other industrial sector.

Where is the breaking point?

If our elected leaders could step above the fray for a moment, they would see it’s easy to draw a direct correlation between PBMs, skyrocketing prescription drug prices, and American healthcare degeneration. America is the only nation in the world that includes PBMs in healthcare, yet we have the highest prescription drug prices in the world.

Does anyone else see the common problem here?

The FTC and the DOJ are currently examining vertical integration legalities. It’s a good start, but it’s not enough. Unless our government is willing to kick healthcare campaign contributions to the curb and focus on what’s best for American patients, nothing will ever be solved.

I implore federal and state governments to mandate full transparency on EVERY aspect of the U.S. healthcare system from campaign contributions to how patient care costs are calculated. The people of this great nation deserve better, and are far more valuable than Wall Street dividends.

Shannon Wightman-Girard

PUTT Operations Manager, Independent Pharmacy Patient