Viewpoints: Drug Pricing

Congress has recently taken a close look at prescription drug pricing abuses, and for good reason, as prescription medications are a part of almost every American’s daily life. Medicare beneficiaries living or undergoing rehabilitation in skilled nursing or assisted living facilities rely on the clinical oversight and medication management that long-term care pharmacies provide. However, LTC pharmacies are beholden to Pharmacy Benefit Managers — a third party negotiator who oversees the pricing structure and reimbursement rate for most generic drugs dispensed by LTC pharmacies to Medicare Part D beneficiaries.

While PBMs claim they aid in reducing prescription drug costs, data suggest otherwise. Secretive pricing practices used by PBMs create unfair reimbursement inequities for LTC pharmacies that actually increase costs. Data show prices paid for the same generic drugs on the same day by different payers can vary considerably, which raises questions about the relationship between price variation and actual market conditions.

Thankfully, U.S. Rep. Austin Scott, R-Ga., is stepping up as an advocate and calling for fairness in prescription drug pricing. He recently supported a bipartisan bill that calls for advancement in payment transparency with regard to how PBMs reimburse LTC pharmacies for generic drugs dispensed to patients. If the current pricing practices of PBMs are able to continue without constructive reform it will ultimately increase the costs to taxpayers and jeopardize quality patient care.

On behalf of Georgians who rely on LTC pharmacies, thank you, Congressman Scott for looking out for our state’s Medicare beneficiaries and taxpayers.