'It's the health care ecosystem, Stupid'

Anyone who was paying attention to President Trump’s May 11th press conference on drug pricing or has read the White House Blueprint understands that drug pricing is an ecosystem that includes manufacturers and multiple intermediaries. Games are being played and patients are (generally) the losers.
 
The president and his team are voicing free-market solutions. The big take-away from the president’s speech is that “the price of drugs” is an ecosystem problem that requires an ecosystem solution. It’s the ecosystem, stupid.
 
Shame on those who perpetuate the myth that drug prices are a one-dimensional issue. And shame those who chose to ignore the many solid recommendations made by the president and his health care team.
 
It’s high time we focused on the questionable practices of Pharmacy Benefit Managers.
 
PBMs receive large rebates and pocket hundreds of millions of dollars rather than pass savings onto patients. President Trump and HHS Secretary Alex Azar said they will demand that these rebates be used to lower patient co-pays at the pharmacy. When people say, “My drugs are too expensive,” what they mean is “My co-pay” or “My deductible” is too expensive.
 
This truth telling isn’t surprising since POTUS is following the lead of three very sharp policy wonks Mr. Azar, Food and Drug Administration Commissioner Scott Gottlieb and Seema Verma, administrator of the Centers for Medicare and Medicaid Services. And they’ve been saying this for years. In fact, Mr. Azar talked about it during his confirmation hearing.
 
The president’s budget calls for insurers/PBMs who provide Medicare Part D prescription drug plans to give at least one-third of the rebates to beneficiaries at the pharmacy.
 
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