The rising cost of prescription medications is a direct result of Tennessee’s pharmacy legislation that was passed in 2021 and 2022. The laws we’re concerned about were promoted by the pharmacy lobby and, we believe, interfere with their right to design and administer their plan in a way that’s best for their companies and their employees.
What does the law do?
One law tries to dictate the pharmacies that employers have to include in their networks. This is a so-called “any willing pharmacy” law, and it doesn’t have exceptions for pharmacies that shouldn’t be in the network, for example, pharmacies that may have engaged in improper conduct in their dealings Tennessee companies and employees.
Another law tries to prevent employers from offering better pricing and lower copays that might encourage a patient to use an employer-owned pharmacy. Still another requires the payment of significant dispensing fees to lower volume pharmacies. All these laws benefit the pharmacies but raise costs for employers and employees.
These types of legislative actions are coupled with future ones that can and will financially impact all of us who get our coverage from a self-insured employer. Which is a large majority of us. Future legislation regarding things like white bagging can make us subject to a hospital’s large markups. Hospitals raise the price of things like chemo meds to raise their own profits. Without the ability to ship in those meds from a more low-cost entity.
Another piece of legislation would allow something called a point-of-sale rebate. That might sound appealing but would ultimately raise premiums for everyone. Allowing direct dissemination of rebates at the pharmacy counter would only raise the premiums for everybody on that plan. Any perceived savings would be masked by these price increases elsewhere.
It’s a tangled web of legislation and profits. Ultimately it is up to all of us to get educated about the cost of our healthcare. We can’t fall victim to buzz worthy phrases that sound like small victories but are ultimately lost war. There are a lot of people who stand to make money off of our personal health and we need to consistently push back against this profiteering.
Sign up to learn more about TN Employer Benefits Alliance here.
Comments