Former MA Governor Jane Swift and Daughter Lauren Hunt Featured in “Patients Not PBMs” Advocacy Campaign
For Immediate Release:
Nov 1, 2023
BOSTON, MA - Patients Not PBMs, a coalition of patient advocacy groups, independent pharmacists, industry and labor formed earlier this year to push for pharmacy benefit manager (PBM) reform, has unveiled new advertising that features former Massachusetts Governor Jane Swift, and her daughter, Lauren Hunt, talking about how PBMs have failed them in treating a rare form of juvenile arthritis.
In order to treat her condition, which Lauren described in an opinion piece in June, she depends on medication and is at the mercy of prescription benefit managers, or PBMs, that determine which medicines will be covered by health insurance plans and how much patients will pay for their prescription drugs. In the new ads, Lauren talks about how difficult it was to get access to her medication. “Without the right medication, it’s too painful to get out of bed - let alone work…But I often can’t get it because of PBMs. These corporations are middlemen. They don’t make the drugs, but they make billions of dollars tying up patients in red tape and making us pay more.”
Gov. Swift brings her perspective as a mother who tried to intervene and help her daughter navigate the PBM maze, only to be tied up in an endless loop of customer service calls and medication denials. “These are some of the richest corporations in the country, and I saw firsthand how badly they treat patients. The PBMs get away with it because they’re not held accountable. Massachusetts can put patients first by cracking down on PBMs.”
Ads began running this fall on streaming and “over the top” (OTT) services, such as Hulu and YouTube TV, along with targeted digital and social media. Last June, the Joint Committee on Health Care Finance held a hearing on several PBM reform bills, and heard testimony from Gov. Swift and Lauren, as well as several members of the Patients Not PBMs coalition, including Todd Brown of the Massachusetts Independent Pharmacists Association (MIPA), and Erin Callahan, Chief Operating Officer of the Diabetes Patient Advocacy Coalition (DPAC).
Other organizations actively engaged around much-needed PBM reform have recently joined the coalition, including the Pharmaceutical Industry Labor Management Association (PILMA), and the Massachusetts Pharmacists Association. Many of these organizations are also advocating at the federal level, as the issue impacts patients as well as many independent and smaller pharmacists who are increasingly squeezed financially by PBMs.
About PBMs
PBMs are a major driver behind the high cost of prescription drugs. Acting as middlemen, PBMs use their consolidated market power to steer patients toward affiliated or preferred retail pharmacies. Over the past decade, PBMs have implemented narrow networks that incentivize or require patients to fill prescriptions at specific pharmacies that are either affiliated with the PBM or that agree to accept lower reimbursement rebates as a condition of network participation. Unfortunately, this does not mean the cost of patients’ prescriptions are lower at the preferred pharmacy; in some cases, the cash price at competing pharmacies is significantly lower than the insured price at preferred pharmacies.
Five of the six biggest PBMs are part of large, vertically integrated organizations. There is significant ownership overlap between PBMs, health insurers, specialty and mail-order pharmacies and provider organizations. Today’s “big three” PBMs – Express Scripts, CVS Caremark, and OptumRx — control over 80 percent of the market, covering roughly 180 million prescription drug customers, and are grabbing tens of billions of dollars in rebates and discounts on medicines that should be passed on to consumers.
About Patients Not PBMs Coalition
Patients Not PBMs is a coalition of organizations formed to raise awareness around how pharmacy benefit managers (PBMs), or "middlemen," are putting profits before consumers' healthcare. The coalition’s focus is to educate consumers about PBMs, and to advocate for policy actions in Massachusetts that will prevent PBMs from continuing to drive up the price of prescription drugs by taking savings away that should be passed along to consumers. Members include a broad cross-section of patient advocacy groups, pharmacists, industry and labor.
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Contact:
Eileen O’Connor
eileen@keyserpublicstrategies.com
c: 617-806-6999
