December 4, 2022
The senators’ mention of pharmacy services was especially interesting, given the recent cut of pharmacy services to Washington’s large military population due to the greed of pharmacy benefit managers – the actual threat to Washington consumers, workers and underserved communities.
Last month, Tricare, the federal insurance program that provides prescription drugs benefits to veterans and active military families, abruptly cut 15,000 independent, local and rural pharmacies from their network. The reason? Express Scripts, Tricare’s exclusive pharmacy benefits provider, decided it can make far greater profits by prioritizing self-owned pharmacies over widespread access for Tricare beneficiaries.
Express Scripts, with revenue exceeding $120 billion, highlights the larger problem with benefit managers across America’s health care system. More than 80 percent of the prescription drug market is controlled by three powerful providers, who act as middlemen between drug makers and pharmacy outlets. The pharmacy benefit managers decide what they pay drug manufacturers, what drugs will be covered in health plans, and what patients will pay, including out-of-pocket costs. Benefit practices deliberately lack transparency; actual costs are hidden from consumers, making the benefit providers the leading driver in higher prescription drug prices.
Earlier this month, Sens. Maria Cantwell and Patty Murray sent a joint letter to Federal Trade Commissions Chair Lina Khan expressing concerns around the Kroger-Albertsons merger, stating “underserved communities throughout Washington benefit from these stores and what they provide in price competition, convenience, high-quality nutritional access and pharmacy services.”
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