Urge Congress to pass the dr U g Act: Protecting patient access and enhancing affordability of medications

t he exorbitant healthcare costs in the United states continue to hinder millions of Americans from obtaining essential treatments necessary for a healthier, fuller life. As an individual who recently survived a stroke and now heavily relies on various prescription medications, I can personally attest to this challenge. Congress must take decisive action to alleviate the burden of healthcare expenses and improve patients' access to vital prescriptions.

Addressing the exorbitant outof-pocket costs associated with prescription drugs is an ideal starting point. even individuals with comprehensive insurance coverage are burdened with substantial additional charges, especially given today's inflation and the high cost of living. Consequently, many patients may find themselves deferring or forgoing the pickup of prescribed medications altogether, ultimately compromising their health outcomes. the frustrating reality is that a significant factor contributing to these soaring costs is the profit-driven conduct of insurance companies and their Pharmacy Benefit managers (PBms). With limited oversight and accountability, PBms currently control a staggering 80% of the prescription drug market. they exploit their market power to dictate the precise conditions for patients to access their essential prescriptions.

PB m s employ detrimental policies, such as prior authorization and prescription "steering." these tactics often result in significant delays in accessing care, disproportionately impacting patients with chronic or terminal health conditions. Additionally, steering compels patients to seek medications exclusively from the pharmacies owned or affiliated with PBms, further exacerbating access barriers and forcing individuals to go to great lengths to obtain doctor-prescribed treatments. however, prior authorization and patient steering policies are not the sole ways PBms undermine patient access, seeking to cut costs and bolster profits. As intermediaries between drug manufacturers and insurance companies, PBms negotiate discounts on certain drugs. these discounts should be passed down to patients to reduce out-of-pocket expenses at the pharmacy counter. furthermore, PBms often exploit loopholes, pocketing the savings from drug discounts and rebates instead of sharing them with consumers. this practice further boosts their already substantial profits while compelling millions of patients nationwide to bear high out-of-pocket costs. such an approach undermines the fundamental principles on which our healthcare system should operate. thankfully, bipartisan legislation known as the DRUG Act is currently under consideration in the senate, offering a viable solution to address the growing threat to patient access and affordability posed by PBms. If enacted, this bill would effectively rein in and reform some of the most harmful practices employed by PB m s, ensuring that patients' health, safety, and well-being take precedence over profit-driven motives. the senate must act swiftly to pass the DRUG Act, and the house of representatives must follow suit. While this legislation may not singlehandedly resolve all the challenges contributing to the high cost of healthcare, it represents a significant stride forward in holding PBms accountable, reducing out-of-pocket expenses, and strengthening access to essential care for millions of Americans.

By enacting the DRUG Act, Congress can demonstrate its commitment to protecting patient rights, enhancing affordability, and ensuring that healthcare remains accessible to all those in need. the time for action is now.

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The opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs and viewpoints of the Asian Journal, its management, editorial board and staff.