A Red State PBM Rebellion?

Wendell Potter FTW again. (Link in Comments)

Pharmacy Benefit Managers (PBMs) have been dodging accountability for decades. Now the curtainโ€™s finally getting yanked.

This Substack by Jay Hancock is required reading if you care about patients, drug costs, or the actual functioning of healthcare. TL;DR: the so-called middlemen in drug pricingโ€”who love to pretend they โ€œnegotiate savingsโ€โ€”are under bipartisan fire for inflating costs, skimming profits, and manipulating access. The rebellion is real. And itโ€™s personal.

Since the late 90s, I've been fighting for patient rights, trying to help people not just survive cancer, but survive the system that comes with it.

And the PBM racket? (Spoiler alert) Itโ€™s one of the most abusive, opaque, and damaging pieces of that system. Iโ€™ve seen firsthand how a recommended drug goes from being "on formulary" to "sorry, not covered" with zero explanation. Iโ€™ve watched caregivers rage as they get handed $8,000 bills because a treatment suddenly requires โ€œstep therapy.โ€ Iโ€™ve talked to pharma execs who *want* to reduce patient prices but are shackled by rebate games and non-transparency contracts.

If you've ever wondered why a life-saving med gets switched to a less-effective one mid-treatment, look straight at the PBMs. If youโ€™re in healthcare and still donโ€™t understand how PBMs operate, thatโ€™s not an accidentโ€”itโ€™s by design.

Are we finally at a tipping point?

Patients, payers, pharma, and policymakers: are you ready to blow this up? Or are we going to let another decade go by while people suffer and middlemen cash in?

Iโ€™m paying attention. So should you.

SOURCE โžก๏ธ

HEALTH CARE un-covered
There is a Rebellion Against PBMs in State Capitals, Not Just in Washington
Executives of pharmacy benefit managers (PBMs) have been dragged in front of Congressional committees for their role in inflating drug prices and undercutting local pharmacies, so itโ€™s no wonder why headlines may make folks think that PBM reforms are only being considered in Washington, but that is far from the caseโ€ฆ
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