Peter Pitts

Peter Pitts

Fed probe may expose reason for high med prices

Spread the love

By Peter Pitts

The Federal Trade Commission now has a golden opportunity to expose why so many Americans are getting fleeced on prescription medications.

The agency has just voted unanimously to conduct an inquiry into the business practices of America’s silent medical middlemen, giant corporations known as “pharmacy benefit managers.”

GSWNH PeterPitts 072922

Peter Pitts

Such a probe is long overdue. Drug makers are often painted as the villains for high drug prices, but PBMs are the real profiteers.

The three biggest PBMs, which own or are owned by the nation’s largest health insurers, control nearly 80% of the prescription medicine market. One of their principal jobs is to negotiate discounts with drug companies.

PBMs shroud their negotiations in secrecy. They aren’t legally bound to operate transparently, nor is there any requirement that discounts they negotiate get passed on directly to patients. These discounts increased from $89.5 billion in 2016 to $175 billion in 2019. This leaves sick Americans paying needlessly high prices for life-saving medications while PBMs and their insurer partners get rich.

Suppose the retail price for a drug is $500, and a patient’s insurance company obligates him to pay 20% of the cost. That means he has to pay $100. But if the PBM secured the drug for $300 — a fairly typical discount — the patient’s share wouldn’t drop to $60, as you might expect. He’d still be billed $100 — and wouldn’t have any idea that his insurer picked his pocket and lined its own.

PBM profits are soaring. They and other non-manufacturers in the drug supply chain managed to pocket 51% of the $686.9 billion spent on prescriptions in 2020. That’s quite a jump from the 37.2% middleman share in 2013 — and not a bad haul for paper-pushing entities that produce nothing.

Rising co-pay and co-insurance costs have led three out of every 10 adults to stop taking their medications as prescribed, according to a recent poll by the Kaiser Family Foundation. By making prescriptions less affordable, the insurer/PBM nexus drives up overall health costs as patients skip doses and end up needing expensive hospital stays.

It took a while for the FTC to get to yes on launching this inquiry, which begins as a basic study of PBM business practices but could lead to enforcement action down the road as the truth comes out. Cozy relationships and self-dealing with affiliated pharmacies and insurers and discriminatory practices against independent pharmacies are now the norm.

The FTC inquiry offers the best hope for a comprehensive review of PBM practices nationwide. As patients have been feeling the squeeze on prescription costs, PBMs and their affiliated insurers and pharmacies have been secretively maximizing their opportunities for profit. When consumers learn what’s really going on, they will know exactly where to direct their outrage.

Peter J. Pitts, a former FDA Associate Commissioner and member of the United States Senior Executive Service, is President of the Center for Medicine in the Public Interest and a Visiting Professor at the University of Paris School of Medicine. This article was first published in the Washington Times.

Local News

Richards won its own regional on Feb.4 behind the efforts of Katie Barr (from left), Natalie Stahulak, Mia Montes, Ulyssa Garcia, Laurin Jacobs, Kylie Schaefer, Andrea Abarca, Yasmine Maali, seen here with head coach Ed Fink and assistant coach Brian Waight. The Bulldogs advanced to the Oswego East Sectional. Photo by Mike Walsh

Girls Bowling | Richards wins regional; Shepard’s Kahlen Ranson rolls to individual title

Spread the love

Spread the loveBy Mike Walsh Correspondent Screaming and cheering parents and friends expressing their staunch support for their bowlers. Teammates fervently hoping for an opportunity to advance to sectional competition next weekend. For good measure, not one but two gender-reveal parties getting ready to begin a few lanes away. Quite a vibrant atmosphere for a…

Sandburg's competitive cheerleaders perform Saturday in the IHSA finals in Bloomington. Photo by Jeff Vorva

Cheerleading State Finals: Sandburg takes fourth behind conference rivals

Spread the love

Spread the loveBy Jeff Vorva Staff Writer BLOOMINGTON — Sandburg’s competitive cheerleaders finished fourth in a state finals competition that looked a lot like a SouthWest Suburban Conference meet. At least it did for the Large Team division competition, in which the top five finishers hail from the SWSC. The 2023 state finals were held…

Nazareth's quest for a state championship starts on Tuesday. Nazareth photo

Area Sports Roundup | Nazareth girls clinch conference crown with win over Carmel

Spread the love

Spread the loveBy Jeff Vorva Staff Writer Nazareth’s girls basketball team is eyeing a Class 3A state championship after finishing second to Carmel a season ago. The Roadrunners whipped the Corsairs, 48-24, Feb. 4 to win the East Suburban Catholic Conference for the second straight year. It marked coach Ed Stritzel’s 400th career victory. Nazareth…

SRP-IMAGE-Logo

Girls Bowling | Reavis wins second straight regional crown; Argo’s Sara Flynn take indie title

Spread the love

Spread the loveBy Mike Walsh Correspondent Two years, two consecutive regional championships for Reavis’ girls bowling team. The Rams made it back-to-back titles in an impressive manner, topping the 13-team field at the Reavis Regional with a pinfall total of 4847, topping second-place Argo (4684) by 163 pins at Palos Lanes in Palos Hills Reavis…

Promoter Katie Goggin discusses the Countryside Summer Concert series. She has to book acts well in advance. (Photo by Steve Metsch)

Countryside plans summer concert series, bluegrass festival

Spread the love

Spread the loveBy Steve Metsch It might be winter, but it’s never too soon to talk about summertime music. Such was the case Jan. 11 when the Countryside City Council’s Special Events Committee heard from promoter Katie Goggin regarding the city’s annual Summer Concert Series. The committee also heard about the second annual Bluegrass and Brews Festival…

Newly elected Judge Nick Kantas gives the oath of office to Senator Mike Porfirio. (Supplied photos)

Porfirio resigns township post to take Senate seat

Spread the love

Spread the loveBy Steve Metsch Mike Porfirio is now a state senator and the Township of Lyons Board of Trustees has a vacancy. Porfirio submitted his resignation as a trustee, which was accepted by the board at its Jan. 10 meeting. Porfirio was elected to the Illinois Senate in November, and was sworn in as…

Deputy Police Chief David DeLeshe (left) and McCook Mayor Terrance Carr said the new drone will help investigate crimes. It can also be used to find hot spots in fires. (Photos by Steve Metsch)

Drone takes McCook crime fighting to new level

Spread the love

Spread the loveBy Steve Metsch The McCook Police Department has a new weapon to fight crime. A new drone equipped with an infrared camera and the ability to zoom in 200 times was at the village’s latest board meeting on Jan. 17. The village used part of a $50,000 grant from the Secretary of State’s…

CRRNH_CathSchoolsWeekOLS_020823

Super Hero fun at Our Lady of the Snows

Spread the love

Spread the love Catholic Schools Week was plenty of fun this year at Our Lady of the Snows School, as students were encouraged to dress as a super hero. Parents interested in checking out the school, 4810 S. Leamington, for 2023-24 are encouraged to call (773) 735-4810. – Supplied photo

new lane configuration 2-6-23

Tri-State lane closures start Monday as area ramps prepare to reopen

Spread the love

Spread the loveOvernight lane closures are scheduled next week to shift traffic on Interstate 55 and on the northbound Tri-State Tollway (Interstate 294) between Willow Springs Road and Plainfield Road and reopen the ramp connecting northbound I-294 to southbound I-55 and Wolf Road. On Monday, February 6, beginning at 9 p.m. and continuing until 5…

Newly installed Orland Park Area Chamber president Ramzi Hassan addresses members during last week’s installation dinner. (Photos by Steve Neuhaus)

Comings & Goings: Orland Area Chamber installs new officers

Spread the love

Spread the loveRamzi Hassan of Edwards Realty Company was installed last week as president of the Orland Park Area Chamber of Commerce. The 2023 board of directors was also installed and annual membership awards were handed out during ceremonies last Thursday at the Crystal Tree Country Club. Installation duties were performed by Orland Park Mayor…

Neighbors

DVN JCs Restoration House Ad
Richards won its own regional on Feb.4 behind the efforts of Katie Barr (from left), Natalie Stahulak, Mia Montes, Ulyssa Garcia, Laurin Jacobs, Kylie Schaefer, Andrea Abarca, Yasmine Maali, seen here with head coach Ed Fink and assistant coach Brian Waight. The Bulldogs advanced to the Oswego East Sectional. Photo by Mike Walsh

Girls Bowling | Richards wins regional; Shepard’s Kahlen Ranson rolls to individual title

Spread the love

Spread the loveBy Mike Walsh Correspondent Screaming and cheering parents and friends expressing their staunch support for their bowlers. Teammates fervently hoping for an opportunity to advance to sectional competition next weekend. For good measure, not one but two gender-reveal parties getting ready to begin a few lanes away. Quite a vibrant atmosphere for a…

Sandburg's competitive cheerleaders perform Saturday in the IHSA finals in Bloomington. Photo by Jeff Vorva

Cheerleading State Finals: Sandburg takes fourth behind conference rivals

Spread the love

Spread the loveBy Jeff Vorva Staff Writer BLOOMINGTON — Sandburg’s competitive cheerleaders finished fourth in a state finals competition that looked a lot like a SouthWest Suburban Conference meet. At least it did for the Large Team division competition, in which the top five finishers hail from the SWSC. The 2023 state finals were held…

Nazareth's quest for a state championship starts on Tuesday. Nazareth photo

Area Sports Roundup | Nazareth girls clinch conference crown with win over Carmel

Spread the love

Spread the loveBy Jeff Vorva Staff Writer Nazareth’s girls basketball team is eyeing a Class 3A state championship after finishing second to Carmel a season ago. The Roadrunners whipped the Corsairs, 48-24, Feb. 4 to win the East Suburban Catholic Conference for the second straight year. It marked coach Ed Stritzel’s 400th career victory. Nazareth…

SRP-IMAGE-Logo

Girls Bowling | Reavis wins second straight regional crown; Argo’s Sara Flynn take indie title

Spread the love

Spread the loveBy Mike Walsh Correspondent Two years, two consecutive regional championships for Reavis’ girls bowling team. The Rams made it back-to-back titles in an impressive manner, topping the 13-team field at the Reavis Regional with a pinfall total of 4847, topping second-place Argo (4684) by 163 pins at Palos Lanes in Palos Hills Reavis…

Promoter Katie Goggin discusses the Countryside Summer Concert series. She has to book acts well in advance. (Photo by Steve Metsch)

Countryside plans summer concert series, bluegrass festival

Spread the love

Spread the loveBy Steve Metsch It might be winter, but it’s never too soon to talk about summertime music. Such was the case Jan. 11 when the Countryside City Council’s Special Events Committee heard from promoter Katie Goggin regarding the city’s annual Summer Concert Series. The committee also heard about the second annual Bluegrass and Brews Festival…

Newly elected Judge Nick Kantas gives the oath of office to Senator Mike Porfirio. (Supplied photos)

Porfirio resigns township post to take Senate seat

Spread the love

Spread the loveBy Steve Metsch Mike Porfirio is now a state senator and the Township of Lyons Board of Trustees has a vacancy. Porfirio submitted his resignation as a trustee, which was accepted by the board at its Jan. 10 meeting. Porfirio was elected to the Illinois Senate in November, and was sworn in as…

Deputy Police Chief David DeLeshe (left) and McCook Mayor Terrance Carr said the new drone will help investigate crimes. It can also be used to find hot spots in fires. (Photos by Steve Metsch)

Drone takes McCook crime fighting to new level

Spread the love

Spread the loveBy Steve Metsch The McCook Police Department has a new weapon to fight crime. A new drone equipped with an infrared camera and the ability to zoom in 200 times was at the village’s latest board meeting on Jan. 17. The village used part of a $50,000 grant from the Secretary of State’s…

CRRNH_CathSchoolsWeekOLS_020823

Super Hero fun at Our Lady of the Snows

Spread the love

Spread the love Catholic Schools Week was plenty of fun this year at Our Lady of the Snows School, as students were encouraged to dress as a super hero. Parents interested in checking out the school, 4810 S. Leamington, for 2023-24 are encouraged to call (773) 735-4810. – Supplied photo

new lane configuration 2-6-23

Tri-State lane closures start Monday as area ramps prepare to reopen

Spread the love

Spread the loveOvernight lane closures are scheduled next week to shift traffic on Interstate 55 and on the northbound Tri-State Tollway (Interstate 294) between Willow Springs Road and Plainfield Road and reopen the ramp connecting northbound I-294 to southbound I-55 and Wolf Road. On Monday, February 6, beginning at 9 p.m. and continuing until 5…

Newly installed Orland Park Area Chamber president Ramzi Hassan addresses members during last week’s installation dinner. (Photos by Steve Neuhaus)

Comings & Goings: Orland Area Chamber installs new officers

Spread the love

Spread the loveRamzi Hassan of Edwards Realty Company was installed last week as president of the Orland Park Area Chamber of Commerce. The 2023 board of directors was also installed and annual membership awards were handed out during ceremonies last Thursday at the Crystal Tree Country Club. Installation duties were performed by Orland Park Mayor…

CRR NH Foran Funeral Home House Ad
CRR NH In Realty House Ad