Why SB 45?
SB45 is essential because it addresses the mounting evidence that Pharmacy Benefit Managers (PBMs) are causing harm to patients, pharmacists, and plan sponsors. PBMs drive up drug prices by retaining rebates and pushing independent pharmacies out of business, while expanding their own control over more pharmacies. They contribute to the rising cost of healthcare, making it even harder for patients to afford the medications they depend on for their health.
PBMs are not partners in healthcare working to improve people's well-being. Instead, they use their power in the prescription drug market to exploit patients, plan sponsors, and pharmacists.
One of their unfair practices is altering reimbursement amounts after the fact. When pharmacies submit claims in real time, PBMs show the amount they will be reimbursed. However, after the prescription is dispensed, PBMs often change the reimbursement or impose fees that weren’t disclosed at the time of the claim submission. Imagine being promised a certain wage for a job, only to find out afterward that your pay has been lowered without notice.
Every day, new studies emerge linking PBM marketing tactics to patients' inability to access medications, increasing drug prices, and the closure of independent pharmacies. The legislation proposed in SB45 brings much-needed reforms that have already been adopted in other states and federal plans. Missouri deserves the same protections.
A study published in the Journal of the American Medical Association (JAMA) revealed that PBMs earn more from the sale of a prescription than pharmacists, wholesalers, or even manufacturers. Remarkably, PBMs don’t even handle the product—they are simply computerized systems that process claims.
Please support SB45 to protect patients, purchasers, and independent pharmacies.
