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As the only pharmacist currently sitting in Congress, I was encouraged to read Scott Atlas's "How to Reduce Prescription Drug Prices: Do Not Harm, First" (February 14).
I fully agree that intermediaries have far too much control over our drug supply chain and I have been very encouraged by the Trump administration's efforts to limit the market tactics used by benefit managers of pharmacies.
That's why I'm proud to see a bill that I co-authored with members on both sides of the aisle banning the ban on gagging clauses last October. As described by Dr. Atlas, because of a restrictive covenant, PBMs had the ability to contract out pharmacists from offering drugs that a drug would be less expensive if it was purchased for cash. There is absolutely no reason why a pharmacist should be forced to operate in fear of retaliation for telling his patients that there are cheaper payment options available to them. they pay out of pocket.
The blatant tactics of PBMs increase costs for patients without bringing tangible benefits. The ban on restrictive clauses is a first step in prioritizing patients over prescription drug intermediaries, and I hope we can do more at this convention.
Now is the time to look at the bigger picture and stop the efforts that drive up costs for consumers and drive up drug prices. The most immediate and significant impact we can have on the price of prescription drugs is the transparency and disclosure of the intermediary. Patients need transparency and deserve not only for their portfolio, but for the longevity of our health care system.
Representative Earl L. "Buddy" Carter (R., Ga.)
Pooler, Ga.
Most drugs offer only hope or the possibility of an extension of life. We all have a limited life span and medications (or medical care) can adjust it a bit. Interestingly, some new anti-cancer drugs introduced in recent years honestly promote the marginal and uncertain benefits of a "chance to live longer" in their television advertising. These drugs are often sold at extraordinary prices to reach the coveted sales levels necessary for their companies to continue to innovate in a scenario characterized by a limited life cycle of the product cycle resulting from the ease of entry into the market. copies after the expiration of the patent. If we recognize the "inverted" model that allows companies to achieve a targeted turnover in a small market (eg cancer) relative to a large market (eg hypertension), then it is clear that may exist a limited or questionable value proposition of prescription offers of today.
Perhaps the best we can hope for is better information and intelligent thinking about the value of making decisions about using expensive prescription drugs, or at least a better understanding of what we buy and why . It may not be the pharmacies we need to buy, but the drugs themselves.
Em David H. Kreling
University of Wisconsin
Madison, Wis.
Saying that shopping in different pharmacies for the cheapest possible medicine not only goes against the "first, do no harm" principle, but could also be totally irresponsible for the patient's health.
What about the burden this places on patients? They spent hours going to different pharmacies, looking for various discount cards and waiting for their prescriptions to be executed. I've seen patients lose whole days looking for a few prescriptions, which allowed them to save a few dollars. Is it the health care we want? PBMs are a problem for patients and the health care system, but we need a less fragmented and stronger system to be safe and offer the best care at the best price at the best price.
Alastair Hay, Pharm.D.
Atlanta
I would like the government to develop a patent formula for the "reasonable" costs of drugs that equitably dictate the number of years needed for society to recover R & D and drug production expenditures, which that would also make a reasonable profit "Generic drug companies", who do not do any research to find treatments for diseases, can make their leap and make a huge profit.
Ryan Searle, M.D., ABEM
Bonita Springs, Florida
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