The way I read the recent opinion piece by Bill Tayler, Dan Liljenquist and Pierce Bassett, the rebates paid by drug manufacturers to pharmacy benefit managers (PBMs) are essentially bribes to convince insurers to prioritize a specific drug instead of relying on doctor expertise.
Of course insurers are against doing away with such rebates. Who would turn their back on legal bribes? The editorial is correct in identifying rebates as something that is wrong with our health system.
Not so with their take on the coupons drug companies give individuals who cannot afford copays charged by insurers.
Let’s say a drug costs $100 and the insurer pays $90 and the patient pays a $10 copay. Whether the insurer gets the copay or the drug company gets the copay, the real issue is that the insurer only pays $90. Maybe there is a difference in distribution of the patient’s cash copay and a coupon, but shouldn’t a patient’s often life-saving drug be more important than a small addition to the insurer’s bottom line? Especially since the drug prescribed and covered is often the drug the insurer covers as a result of the bribe..er rebate.
Patients and doctors don’t deliberately game the system. Doctors prescribe what is best for the patient, and if the patient can afford it, that is the drug taken. SB184 is a godsend for those people with life-threatening and/or disabling medical conditions. People who believe health is more important than insurer’s profit should urge their representatives to support this bill in the Utah House of Representatives.
Richard Steiner, Salt Lake City
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