Big Pharma
Re “Big Pharma wants state law to change. Virginia should say no.” (Other Views, Aug. 26): The guest columnist is correct in that we pay significantly more than we should for our prescriptions, but he does not fully understand the role of the pharmacy benefits manager. The PBM serves as an intermediary between health plans and pharmaceutical companies. In other words, they do all of the scut work that Big Pharma doesn’t want to do. The problem with PBMs is that many are part of major pharmacy chains, such as CVS, which benefit by owning the PBM. For example, CVS can dictate to the PBM what it will tell the health plan about the payment for a set formulary of drugs.
So, Big Pharma tells the pharmacy what they will have to pay to sell their drug, the chain pharmacy will tell the PBMs what to tell the health plan that the cost will be, and then the health plan has to decide if they want to pay for the drug and pass the cost on to the consumer at higher rates or not carry the drug as part of their benefit.
“Discounts” are dictated by Big Pharma before the annual process begins. Big Pharma determines who will be eligible and how many discounts will be issued in a given year. This is non-negotiable. The pharmacy manages the discount, which may not actually be a discount, as the cost to the consumer may have been inflated to make the discount appear more substantial.
Part of how PBMs are paid is through a percentage of the cost of the drugs prescribed via that health plan. Eliminating the PBM would certainly lower prescription costs, but this would not address the larger issue of Big Pharma.
Talbot N. Vivian, Yorktown
Jason Miyares
Why do I get the impression that Virginia Attorney General Jason Miyares is “freaked out” in his bid for reelection? Thus far, the only ads we’re seeing are “desperation ads” attacking Democratic candidate Jay Jones.
What has Miyares accomplished these past four years? And what does he hope to accomplish the next four years if he’s reelected?
At this point, I’m unimpressed with Miyares and his ads. Thank God for mute buttons.
Billie M. Cook, Portsmouth
Ironies
Following MAGA’s electoral success in November, many people have since noticed that ironies now abound, as we witness the piecemeal sabotage of much that once made America historically a great country.
We thought our long tradition of personal freedom was secure. This is now but a memory, since we must abide ICE officers in our midst. Anytime, anywhere, anyone can be hauled off to parts unknown, with precious little recourse.
Some Americans who are currently enrolled in Medicaid and/or SNAP have recently discovered that these may not be available to them. Why not? Because this assures that the wealthy can keep indulging themselves, thanks to their enormous tax cuts.
The Environmental Protection Agency was created to be the public’s friend, yet in a The Week newsmagazine article EPA Administrator Lee Seldin said he “intends to argue that imposing climate-related regulations on auto manufacturers harms human health because ‘it leads to higher prices and reduced consumer choice’! ”
Andreas Kluth wrote in The Week: “Never had [America] been blessed with such an abundance of ‘soft power’ [e.g., USAID], yet forfeited so much of it with so little justification.” By contrast, China, our archrival, is extending its influence into countries that we have foolishly abandoned.
How could we, the American public, have expected a stable government, yet then elected a president who had spent so much of his working life, over a span of 20-plus years, in the close company of mobsters?
Stan Pearson, Newport News
