Early in July, Florida Governor Ron DeSantis joined a fight I’ve been waging in Mississippi for the last few years: the fight to hold giant companies called Pharmacy Benefit Managers accountable. The news from Gov. DeSantis—who’s a real fighter—was welcome because it means more states are stepping up to take on these companies and lower drug prices.
First, a little background. Pharmacy Benefit Managers (PBMs) are large companies that sit between your pharmacist and your health plan. The reason they were created was to manage the payments that would flow from your health insurance plan to your local pharmacist to pay for your drugs. They were also supposed to negotiate drug prices with the big pharmaceutical companies to get deals for us, the customers.
Over time, though, PBMs became powerful “middlemen” to borrow Gov. DeSantis’s phrase. He has noted they are driving “upward pressure” on drug prices. And I have noticed that our local independent pharmacists are being crushed by these PBMs.
So, nearly four years ago, I went into action. My office and the Office of the Ohio State Auditor both launched investigations into the PBMs. On our end, we wanted to see if the PBMs were charging more for drugs when they were serving Medicaid patients. If they were, the taxpayers might be footing the bill. After months of fighting to get financial records and data analysis, the team of experts who worked for both Ohio and for me came to the conclusion that our states were not getting a square deal from the PBMs.
Several months later, Ohio obtained an $88 million settlement from the large company that owned the PBM they investigated. On the same day, Mississippi obtained a $55 million from the same company. The news was covered in The Wall Street Journal. We were the first two states to hold these PBMs accountable, but now, as Florida is proving, the fight is spreading across the country. Our $55 million settlement was the largest civil settlement ever resulting from a State Auditor investigation in our state’s history.
As that investigation was going on, I had some people tell me it was suicide to go against such a powerful company. The company we were investigating is one of the largest political campaign donors in the state. But it’s my job to stand up for you, the taxpayers. That means taking on all comers.
If we want to lower drug prices and alleviate some of the pressures on our local pharmacists, we need more fighters like Gov. DeSantis. I talk to pharmacists every week who are teetering on the edge of collapse. Last year, my office surveyed pharmacists around Mississippi. The survey showed over 90% of pharmacists described PBMs as “an obstacle between the patient and healthcare provider, largely responsible for increasing drug prices.” More than a quarter of independent pharmacists that we surveyed are somewhat likely or very likely to close their business in coming years due to PBMs.
I’m grateful Gov. DeSantis is taking the fight that started in Mississippi and Ohio to Florida. With more leadership like that, we can lower drug prices and usher in a better era for customers and local pharmacists.
This article was originally published by Starkville Daily News.