Pastor William D. Smart Jr., Co-Pastor Christ Liberation Ministries . Courtesy photo.

At a Convention of the Medical Committee for Human Rights held in Chicago in March 1966, Martin Luther King Jr. said, “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.” As a pastor and community activist, I know all too well the healthcare injustices faced by minority communities. It’s not a secret that people from these communities are disproportionately affected by a wide range of health issues. And nothing has highlighted and exacerbated the disparities quite like COVID-19.

According to a CDC study, “Long-standing systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19.” In a double-blow to minority communities, not only do they have to worry about treating already present illnesses–there’s an ever-present danger of catching a deadly virus that has already killed more than 242,000 Americans.

Chronic health issues aren’t cheap. Many conditions, such as diabetes, high blood pressure, or asthma, are treated with prescription drugs that are expensive. If someone has more than one health condition to manage (which is frequently the case in minority communities) those trips to the pharmacy can become incredibly expensive as the cost for prescription drugs continues to rise at an alarming rate.

What is shocking and inhumane about prescription drugs–are the actions of the drug manufacturers who create them. These companies continue to gouge prices and profit from life-saving treatments. The pandemic has caused people to lose their jobs, small businesses have closed, the unemployment rate is higher than ever, but–Big Pharma hasn’t suffered and continues to show big profits.

Throughout COVID-19, pharmaceutical companies have continued to raise the cost of prescription drugs. And those who will be most hurt by the ever-increasing rise in the cost of prescription drugs are minority communities.

There are many challenges to making healthcare more affordable and access to affordable medications isn’t the only problem. But when it comes to prescription drugs and pushing back against the actions of Big Pharma, fortunately, this isn’t a fight we have to do alone.

Most people don’t realize the shield that is in place protecting hundreds of millions of us from the price gouging of Big Pharma. Pharmacy benefit managers (PBMs) negotiate on our behalf to reduce the cost and burden caused by pricey medications and they are doing this all day every day.

This mostly unknown player in the healthcare industry negotiates the list price of a drug (set by Big Pharma) with insurance companies to make sure that the cost paid by the patient (you and me) at the pharmacy is affordable. Throughout this pandemic, PBMs have waived early refill fees and offered delivery services so that customers could receive their prescriptions from the comfort of their home. Even though many of us don’t realize that we have PBMs negotiating on our behalf–they’re there, working for us all.

Positive stories about pharmacy experiences stand in stark contrast to the nightmare stories about rationing or forgoing treatments because the patient can’t afford them. The common thread in the good stories–is having a benefit manager working to negotiate the price down from what only insurance alone could cover.

The price of medications is set by Big Pharma. But instead of taking responsibility for their role in increasing prescription drug costs, they paint everyone else in the supply chain as the ‘bad guy.’ PBMs are heavily scrutinized and blamed by the very organization that continues to raise the list price every year.

Pushing back against Big Pharma and looking to groups who advocate for affordable drugs is a social justice issue. The actions of Big Pharma are unacceptable (and frankly, abhorrent) and make for unequal access to life-saving treatments. Advocate negotiators are a good first step in creating a level playing field as we continue to fight for equity in quality healthcare for all communities.

Alleviating the high cost of prescription drugs is just one step at making healthcare costs more affordable for all. There is more work to be done in this area and we know that like everything else—we will have to work harder to ensure minority communities have access to high quality and affordable healthcare. Those who have the power to create policy around this issue should instead focus on holding Big Pharma accountable for their role in increasing costs—rather than demonize entities like PBMs that work to lower it to the benefit of the most vulnerable. We can only make progress on this issue when the blame game ceases to exist, and we work together to solve this issue for vulnerable communities across the state and make the cost healthcare more humane.



Pastor William D. Smart Jr.

Co-Pastor Christ Liberation Ministries 

President/ CEO Southern Christian Leadership Conference -Southern California