FREQUENTLY ASKED QUESTIONS
WHAT IS EMPLOYER-BASED HEALTH COVERAGE?
Employers want healthy workers, and that means providing them with the access and resources needed means to support good health, seek preventative care, treat illnesses and injuries, and take their prescribed medication. Health benefits that provide access to affordable care and medication are also powerful employee retention tools. This is why employer-based health insurance is foundational to American health care as well as our economy.
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There are at least 177 million Americans with employer-based health coverage, compared with 120 million with other coverage and 28 million uninsured. Employer-based health
insurance can be either fully Insured or self-funded.
HOW DO PHARMACY BENEFIT MANAGERS (PBMs) HELP?
Pharmacy benefit managers (PBMs) work on behalf of patients and employers to lower prescription drug costs. They take on Big Pharma , the drugstore lobby, and other special interests to make sure that Tennesseans are paying as little as possible for life-saving medications. Legislators should let them do their work, instead of tying them up in bureaucratic red tape and trying to force employers into one-size-fits-all government mandates.
Lower prices: According to a 2020 study conducted by Visante, PBMs save patients and payers an average of $962 per person per year by encouraging market competition, transparency, use of generic drugs and a variety of other practices and tools that contain costs.
ARE INDEPENDENT PHARMACIES DYING?
Independent pharmacies want you to believe they are struggling to stay in business.
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New pharmacy data reveals that the overall number of independent pharmacy stores increased in the United States over the past decade. There are 2,645 more independent pharmacies than there were in 2011, which is almost a 13% increase over 10 years.
IS BIG PHARMA BEHIND THIS?
No discussion about lowering Rx costs can be realistic without keeping in mind that Big Pharma companies – and Big Pharma companies alone – set the price of Rx, like the nearly $60,000/year price tag on Humira, the world’s best-selling drug.
But that’s not all: Big Pharma companies also use lawsuits and obscure patent laws to tie up the courts, block competition, and keep more affordable generic Rx away from patients who need it most.