I write this petition as a national patient advocate and, most importantly, a concerned parent of a transplant survivor—my young son whose life depends on regular medications every 12 hours. 

After learning from my son’s journey and connecting with patients across the nation, it is certain that Pharmacy Benefit Managers (PBMs) like Optum RX, CVS Caremark, and Express Scripts PBMs' manipulation of drug prices has led to higher costs and driving local pharmacies to close and leaving communities without immediate life-saving access to essential medications. These harmful practices are putting the lives of patients like my son at serious risk.

PBMs, middlemen managing drug benefits for insurers, engage in several price-gouging practices, including "spread pricing." According to a study by the Congressional Budget Office (CBO), this practice alone contributes over a billion dollars to increased drug spending annually.

They use “spread pricing” to buy drugs at discounted rates and sell them at inflated prices, keeping the difference. This inflation is driving average drug price increases of 5.6% annually since 2015, burdening patients, employers, and taxpayers. PBMs are responsible for up to 30% of the inflated costs patients pay, leading to 30% higher drug spending for consumers.

PBMs also steer patients to certain pharmacies, disrupting care and creating barriers to access. A 2020 National Community Pharmacists Association survey found that 75% of independent pharmacies face closures due to PBM practices, and PBMs often push patients to mail-order services, resulting in errors and lower-quality care. This is exacerbating the loss of personalized service from local pharmacists, who are essential to chronic care.

Employers and taxpayers are paying the price too. Recent studies have also confirmed, PBMs imposed markups by hundreds or even thousands of percent on specialty generic drugs used to treat cancer, HIV, and other serious conditions as they steer patients to their own mail order pharmacies.  

My husband is a veteran who fought alongside Defense Secretary Pete Hegseth in Iraq when Pete was his lieutenant in the 101st Airborne, one of the thirty to forty men that were part of the squad. To learn that PBMs like Express Scripts are reducing pharmacy access by cutting thousands of pharmacies from their networks—especially in underserved rural and urban areas—while steering military members to their own mail order pharmacies is unacceptable. many military and veterans are suffering without local pharmacy access. A recent whistleblower lawsuit also clams that Express Scripts is overcharging taxpayers through wasteful spending and overfilling of prescription medications. These actions are demoralizing to every military member, veteran, and their families. Our veterans and military members deserve better. Taxpayers deserve better.

We must end these harmful practices. National surveys such as this, show 80% of Americans support reducing PBM influence on drug pricing and to rein in on PBMs. We urge the Department of Government Efficiency to stop PBMs' wasteful spending and help push forward policies that ensure fairness in drug pricing, protecting America's local pharmacies and patients like my son.

Thank you, 

 

Loretta Boesing, Patient Advocate

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