Georgians are About to Pay $7.3 Billion More for Prescription Drugs

Leanne Gassaway

Monday, July 13th, 2020

Lawmakers in Georgia continue to face pressure to take action on the high price of prescription drugs and the COVID-19 crisis has heightened the urgency around this issue, as states, employers and citizens confront unprecedented financial hardship stemming from the pandemic. 

But instead of targeting the root cause of the problem—the drug manufacturers who set the list price for their products—the focus has shifted toward blaming pharmacy benefit managers (PBMs), the one entity in the drug supply chain that helps lower drug costs. 

Recently, Metro Atlanta CEO published an inaccurate op-ed from the Georgia Public Policy Foundation, “Legislature Acts to Increase Transparency in Drug Pricing,” which is the latest attempt to spread falsehoods about how PBMs impact the high drug prices set by the drug makers.

Right now, Georgia lawmakers have sent two bills — SB 313 and HB 946 — to the Governor that would hurt the people of Georgia by forcing PBMs to operate with both hands tied behind their backs when it comes to reducing drug costs and improving care for Georgians. Most importantly, the bill does nothing to lower the cost of prescription drugs, and in fact will have the opposite effect. 

The goal of a PBM is simple: reduce drug costs for Georgians while providing access to clinically appropriate care. We partner with employers, health plans and government programs here in Georgia to lower drug costs for millions of Americans. Over the next ten years, PBMs are expected to help Georgia employers save $17.1 billion on prescription drug costs, and save patients an average of $962 per person, per year. Meanwhile, drug makers hiked drug prices more than 800 times just this year and increased the cost of 42 drugs by an average of 3.3 percent in July alone – in the middle of a pandemic when families and businesses are hurting.

CVS Caremark is committed to serving Georgians and helping lower costs for members, employers and the state. In addition to our work in delivering more affordable prescription drugs, we also are providing critical services during this crisis. Over the last several months, Coram, our infusion care business, has worked with Piedmont Healthcare here in Georgia to help create needed hospital bed capacity by transitioning eligible IV-therapy patients to the comfort and safety of their homes. We also worked to stand up more than 80 drive-thru COVID-19 testing locations across the state, as well as a community testing site at Good Samaritan Health Center in Atlanta and a mega-testing site at Georgia Tech.

It's unfortunate that despite this clear demonstration of our value, we continue to face baseless claims. The fact is that we play an essential role in providing affordable and needed medications in virtually every zip code of Georgia. 

Contrary to what the author writes, it’s a myth that we show preference to our affiliated pharmacies. We urge the author to stop sharing this unsupported claim – we maintain an accessible network of pharmacies across the state, whether in suburban, urban or rural communities. We have more independent pharmacies in our network than the total of CVS and the other chain pharmacies combined. No matter where Georgians live, they can access a wide network of pharmacies in their community.

SB 313 and HB 946 would devastate the programs and tools that PBMs use to save Georgia’s employers and patients money while helping to improve coordination among health care providers to help patients stay adherent to their medicines. These bills are projected to increase prescription drug costs by $580 million in the next year and $7.3 billion 10 years – costs that will most certainly be passed onto Georgia’s patients and taxpayers. This means more money in Big Pharma’s pocket. And perhaps most concerning is that these bills will jeopardize access to quality, lower-cost prescription drug coverage for millions of Georgians who get their health care coverage through their employer. With economic stress already challenging small employers and families, this is the wrong time to add more costs on working families.

The state of Georgia is also facing critical economic times with a projected $850 million budget shortfall, and these bills could make the state’s finances worse. Last year, Oklahoma passed unnecessary restrictions on PBMs despite fierce pushback from major employers across the state. The measure will cost the state at least $7.2 million[1], leading to increased health care costs for the state, Oklahoma employers and, by extension, consumers and taxpayers. 

We are working hard to ensure that more Georgians stay healthy and have access to affordable health care. As health coverage and fiscal discipline remain top of mind for state officials, businesses and individuals alike, we urge Governor Kemp to heed the cautionary tale of other states that have taken anti-PBM actions – and seen their budgets suffer as a result – and veto these harmful measures.