Most adult Americans take at least one prescription drug, and for too many, getting that prescription filled means battling the very system that’s supposed to help them. Insurance denials have become alarmingly routine. A recent study found that 70% of commercially insured patients face initial claim rejections for new branded medicines. And even when patients manage to access treatment, affordability remains a major challenge: nearly 60% of U.S. adults worry about being able to pay for their medications. At the center of this crisis are the abusive practices of corporate middlemen. America’s vertically integrated mega-insurers and their subsidiary pharmacy benefit managers have grown to control virtually every aspect of healthcare access and affordability and deliberately erected administrative barriers that delay care and inflate costs — barriers felt most acutely by patients managing serious chronic conditions.
OPINION: FIXING AMERICAN HEALTHCARE MEANS FIGHTING BIG PHARMA AT HOME AND ABROAD
Although the Trump administration is taking steps to investigate insurer and PBM practices, it’s time for it to crack down on these bad actors once and for all.
Insurers and PBMs frequently force patients to jump through a maze of hoops to access treatment.
