The Truth Behind Drug Pricing
Prescription drugs save lives, but sudden price hikes without reason or warning can cause patients to skip doses or abandon their treatment altogether.
The Problem
Three key players impact the drug supply chain:
- Pharmaceutical companies set the list price of a prescription drug.
- Pharmacy Benefit Managers (PBMs) negotiate rebates and control which drugs make it onto formularies.
- Health insurers decide how much patients pay out-of-pocket for prescriptions.
These negotiations happen behind closed doors, and while PBMs claim to save patients money, patients are often left with higher medical costs, and the profit-driven players escape without consequence.
About one in seven adults say they’ve cut pills in half or skipped doses of medicine in the past year because of cost. Drug pricing shouldn’t be a guessing game—it should be transparent, fair, and focused on patients.
The Path Forward
Patients, physicians, and health care organizations have been demanding action to increase drug price transparency and insight into the process that impacts their access to care. Together, we can create a strong voice for Washington, D.C. and hold key players accountable for their shady negotiations.
“My family watched as I grew sicker. I am someone’s daughter, sister, best friend, and neighbor, and we all suffered because I couldn’t afford the health care I needed.”
Anna M., Missouri
“I also hope that legislators wake up to the reality of this issue. It’s putting their constituents in real danger. We need leaders that can act for the betterment of the people not to ensure middlemen’s stock prices.”
Webb W., Utah
“My physician increased my dosage by one pill… My medication increased from $25 to $440. I was not prepared for this price hike. This is a convoluted mess! What my physician prescribes me should not need to go through hoops for me to receive the best care.”
Jada M., Minnesota