At the Arming Minorities Against Addiction & Disease (AMAAD) Institute, we are deeply committed to advocating for the health and well-being of underserved communities everywhere, particularly our LGBTQ+ and African American communities.
As we work to address health disparities, we see the significant barriers that opaque Pharmacy Benefit Manager (PBM) practices create for patients seeking affordable, life-saving medications.
At the forefront of this important fight is Representative Nanette Barragán of California. We extend our heartfelt gratitude for her tireless work in pushing for PBM reform. Her efforts are crucial in addressing health equity and ensuring that the African American community and other underrepresented communities she serves has access to necessary medications and lifesaving therapies.
PBMs, initially intended to manage prescription drug programs and reduce costs, have evolved into powerful entities that control 80% of the market. This control enables them to significantly influence drug pricing and access to the detriment of underserved communities whose main challenge has been related to access.
Over the last decade, the share of PBM profits from fees charged to manufacturers, pharmacies, health insurers, and employers has increased by more than 300%. Additionally, fees that PBMs charge biopharmaceutical companies in the commercial market have doubled over the past five years, growing from $3.8 billion in 2018 to $7.6 billion in 2022.
These increases in fees highlight a particularly troubling trend: PBMs have been allowed to game the healthcare system to generate more profits, often at the expense of patients, employers, and the broader healthcare system. This profit-driven model results in higher costs and reduced access to medications, disproportionately impacting Black, Latine, and other underserved communities throughout our country.
Representative Barragán understands that health equity cannot be achieved without addressing these systemic issues. It’s one of the primary reasons we’ve previously named her our 2023 AMAAD Champion of Health Equity. Her consistent advocacy for PBM reform has been a critical step towards ensuring that all patients, regardless of their background, socioeconomic status, and identity, can afford the medications they need. By pushing for greater transparency and accountability in the PBM industry, she is fighting to eliminate the practices that hinder access to essential treatments.
We urge Congress to enact PBM reform to stop the manipulation of our health system and instead prioritize the health and well-being of patients everywhere. It is time for Congress to act decisively to implement reforms that will create a fairer, more transparent pharmaceutical landscape. This includes regulating the fees that PBMs can charge, ensuring fair reimbursement practices for pharmacies, and promoting competition to drive down drug prices for the communities we represent.
For too long, PBMs have operated with little oversight, allowing them to maximize profits while patients struggle with rising costs and limited access to care. Reforming this system is not just a policy issue; it is a moral imperative that will help bridge the gap in health disparities affecting African American, LGBTQIA+ and other underserved communities.
Representative Barragán’s continued leadership in this fight is vital. Her efforts represent a beacon of hope for those who have been marginalized by the current system. We call on her and her colleagues in Congress to push forward with meaningful PBM reform legislation that will protect patients and ensure that pharmacists can continue to serve their communities effectively.
The time for action is now. Underserved communities everywhere are watching. And historic reform can take place to ensure adequate access to life saving medications and therapies for all. Reform efforts can create a healthcare system that truly serves the needs of all Americans. The AMAAD Institute stands ready to support these efforts and will continue to advocate for policies that ensure affordable, accessible, and transparent healthcare for all.
Gerald Garth is Executive Director of The Arming Minorities Against Addiction & Disease (AMAAD) Institute, a Los Angeles-based nonprofit that provides essential support services, resources and referrals with a focus among LGBTQ people of color.
