Time to Protect Prescription Affordability in Pennsylvania
For me, pharmacy has always been more than a potential career path – it’s the family business, started by my parents who have proudly served as pharmacists in Pittsburgh since the early 1980s.
Growing up, dinner-table conversation often revolved around pharmacy talk and patient interactions. When I reached high school and discovered my talents and interests lay in math and chemistry, I decided to follow in their footsteps, working as a CVS pharmacy technician while earning my doctorate in pharmacy at Duquesne University.
Today, I work as a Specialty Pharmacy Operations Manager for CVS Health – the same company my parents work for. I run CVS Health’s largest specialty mail-order pharmacy, managing a team of more than 100 pharmacists who work to ensure that patients have convenient access to the life-saving medications they need.
Every day, I am determined to provide the best possible experience for my patients and make my parents proud.
Working at a specialty pharmacy, most of the drugs we dispense treat serious and complex diseases like cancer. These life-saving medications often come with hefty price tags, which can add up to more than $100,000 per year – and cost is a constant concern for my patients.
Fortunately, pharmacy benefit managers (PBMs) go up against drug manufacturers to negotiate lower costs for the labor unions, employers, and patients we serve. In 2023, specialty drug cost growth was just 3.7%, and the overall trend was in the single digits for the seventh consecutive year.
That’s why I am concerned that possible legislation here in Pennsylvania would impede PBMs’ ability to manage costs for patients like mine.
The legislature is considering proposals which could effectively eliminate many of the tools that PBMs use to make medicines affordable, which in turn push costs higher for unions, small business, and patients. For example, one proposal under consideration would prevent employers from being able to tell patients where they can access more affordable prescriptions. For specialty drugs like the ones I dispense, the importance of these cost-controlling tools is magnified.
While I commend lawmakers for making rising drug costs a priority, I urge our representatives in Harrisburg to be cautious of any changes that would weaken the negotiating power of PBMs and, in turn, prevent curbing high drug prices. Instead of restricting the choices that unions and employers have when designing their employees’ pharmacy benefits, lawmakers should look to implement transparency measures for every part of the pharmaceutical drug supply chain, from drugmakers to distributors.
As lawmakers look to lower costs, it’s important they put patients first. I still remember one patient who had been diagnosed with multiple myeloma; we’ll call her Maggie. She required complex treatment that came with a large co-pay totaling thousands of dollars. With a price tag this high, Maggie was nervous she would not be able to cover the cost. After a long day of working the phones, we were able to identify funding for her treatment. It was a privilege to share the good news with Maggie.
When patients, like Maggie, come to me with serious concerns surrounding their ability to pay for their prescriptions, I feel a sense of duty to help ease their worries. In fact, CVS Specialty screens each of our patients to see if they are eligible for foundation grants and other financial assistance to further lower the cost of their specialty medications.
I call on Pennsylvania’s legislature to provide the right policy environment to keep this patient-pharmacist relationship strong. For patients battling serious illnesses, lower prescription drug costs negotiated by PBMs can be life changing.
