Governor Spanberger is Right:
Stopping Insurance Schemes Will Lower Rx Costs.
Virginians work hard – and they deserve prescriptions they can afford. But Virginia families, their doctors, even their pharmacists at the pharmacy counter don’t determine the costs of medicines. Behind the scenes, multi-billion-dollar insurance middlemen are driving up costs and profiting from our prescription drug system.
Pharmacy benefit managers (PBMs) are corporate middlemen, often owned or controlled by large health insurers, that manage prescription drug formularies and pharmacy benefits. PBMs decide which drugs are covered, where patients can fill prescriptions and how much everyone pays. The vertical integration of PBMs, health insurers, major pharmacy chains, and other entities in the drug pricing system has led to unprecedented consolidation, unchecked abuse and profiteering at the expense of Virginians.
Price discrepancies and mark-ups caused by PBMs in particular are hitting Virginians hard - in some cases, PBMs have charged Medicare anywhere from:
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$75 to more than $7,000 for the same cancer drug, and
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$150 to over $3,000 for the same multiple sclerosis medication.
This is not unique to Medicare. The federal 340B program, which was created to help safety-net hospitals and clinics serve low-income and rural Virginians by allowing them to purchase medicines at a discount, is impacted by PBM interference as well. Most pharmacies that contract with 340B hospitals are owned or affiliated with PBMs, allowing these middlemen companies to divert savings meant for patients in need into their own pockets.
Governor Spanberger saw through the insurance scheme and is fighting to lower prices and provide real relief for families at the pharmacy counter..
Governor Spanberger is leading on affordability – standing up for what matters to all Virginians.