PBMs Are the Hidden Danger: Brace for Soaring Healthcare Costs

While the Inflation Reduction Act (IRA) promises savings, those benefits aren’t likely to reach you. As the IRA aims to lower drug prices, there's an overlooked consequence that's about to hit patients hard. The initial financial pain will be felt by Pharmacy Benefit Managers (PBMs)—the middlemen who control access to your medications. And when PBMs feel the squeeze, they pass that pain directly onto patients and employers.

While the IRA started with Medicare drug pricing negotiations, it's a bellwether for what will happen in the private insurance market - what 150 million or so of us rely on from our employers. This means higher insurance premiums, steeper deductibles, and more out-of-pocket expenses for the very people these systems are supposed to protect. The cost will shift, creating a heavier burden on American families and employers struggling to provide health insurance.

PBMs have mastered the art of profit over patient care, and as they maneuver to protect their bottom line. The costs to patients and employers will be devastating. Employers will face skyrocketing insurance costs, and employees will see even more of their paychecks eaten up by healthcare expenses. This isn’t just an economic issue—it’s a crisis of access and equity in our healthcare system.

The U.S. prides itself on innovation, yet our healthcare system is failing to meet the basic needs of its people. The IRA’s good intentions are being undermined by a system that needs broader reform, where transparency and patient-centered policies are paramount.

We can't afford to ignore this. We need immediate action to ensure the financial burden doesn’t fall on those who can least afford it—us, the patients.

The time for health reform is now, before the costs become too high for any of us to bear!

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