With all the divisiveness in American politics and government, there is at least one issue with overwhelming support – almost unanimous. Just about everybody is for lower drug prices.

When you state the proposition the following way, how could someone take the opposing view? Prices for the same drugs are often lower for consumers in other countries than in the United States. Should steps be taken to enable U.S. consumers to buy prescription drugs at the same or lower prices as foreign purchasers?

In 2022, Congress took a step toward lower drug prices. The Inflation Reduction Act passed, doing several things, positive and negative. On the positive side, it enabled government agencies and private associations to negotiate with pharmaceutical manufacturers.

Now, there is a move to roll back some of that price competition. Big pharma wants to restrict private associations that negotiate on behalf of consumers.

S. 127, the rollback bill, would likely cause increased drug prices. The deceptively named Pharmacy Benefit Managers Transparency Act of 2023, sponsored by U.S. Sen. Bernie Sanders (I-Vt.) and others, would put more regulations on private associations that negotiate on behalf of Pharmacy Benefit Managers (PBMs) and ban some of their contracts altogether.

What are PBMs? If the average American has heard of them at all, it is probably on a TV or social media ad accusing them of being “middlemen” who drive up drug costs.

Insurance companies hire PBMs to negotiate with drug makers to get lower drug prices for the people in their plans. PBMs use their size and bargaining power to drive prices down, not up.

There is another issue here that complicates things. Pharmaceutical companies aren’t the only ones who have to negotiate with PBMs. Local pharmacies do, also. PBMs are big and powerful compared to community pharmacies, so negotiating on an even plane is difficult. Multi-billion-dollar drug companies can compete equally with PBMs, but local pharmacies can’t always do the same. This problem could be fixed by letting community pharmacies join with other groups that negotiate with PBMs, such as hospitals and physicians.

Some special interests want to weaken PBMs. Drug companies don’t like that PBMs have the size and bargaining power to cut into their profit margins.

Why is it that the progressive left and big pharma are teaming up to restrict bargaining for lower drug prices? S. 127 would likely raise drug prices and more than just a little bit. If that happens, it could spark an outcry for a single-payer healthcare system with government price controls. Maybe that’s exactly what the left wants. If drug companies have free rein, the American people will get fed up fast and demand a government-controlled system. Defeating S. 127 and allowing continued price negotiating by PBMs would help to keep that from happening.

Jim Zeigler is a former Alabama Public Service Commissioner and State Auditor. You can reach him for comments at ZeiglerElderCare@yahoo.com.

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