LETTERS: PBM Accountability Passed. Now Make It Count.

To the Editor,

The public conversation about prescription drug costs has made real progress, and the PBM accountability legislation that passed was a meaningful part of that. But Pharmacy Benefit Managers still operate with more room to keep savings than Louisiana patients can afford, and the job of fixing that isn't done.

A recent Fox News op-ed made a point worth repeating here. When Most Favored Nation pricing comes up as a solution, the skepticism is warranted. MFN wouldn't touch PBM practices at all and that's where the real problem lives. PBMs collect rebates from drug manufacturers and absorb them, leaving patients to pay full freight at the pharmacy counter. Step-therapy requirements pile on, forcing patients through cheaper alternatives before insurance will cover what a doctor actually ordered. These are business decisions, not medical ones.

Beyond that, the countries with lower prices that MFN would reference have care access limits and waiting periods that Louisianans haven't had to navigate. And squeezing what American pharmaceutical companies can reinvest in research has consequences — especially now, when competitors abroad are gaining ground.

The legislation that passed was a start. Finishing it, real accountability for how PBMs handle the savings they collect, is where patients will actually feel the difference.

Merredith Garner