Column: Legislative proposal for rebate pass-through crucial to accessing lifesaving drugs – Tulsa World

A proposal before the Legislature would send prescription rebate pass-throughs on to the patient.
More than 466,000 Oklahomans are living with diabetes, and an additional 1,040,000 residents, 34.9% of the adult population, have prediabetes. Yet, stories of patients rationing their insulin or not being able to afford it at all are still too common.
Thankfully, this year our state Legislature has the opportunity to help this vulnerable population and countless others living with chronic illness by increasing their access to treatments.
Senate Bill 1324 would require state-regulated health plans to pass negotiated rebates on prescription drugs to plan participants at the point of sale, saving many Oklahomans $1,000 or more annually with minimal effect on the overall cost of premiums.
As a mother whose daughter was diagnosed at the age of 3 and has lived with Type 1 diabetes for the past 34 years, I am encouraged by the consideration of this vital legislation by the Oklahoma Senate Retirement and Insurance Committee and am hopeful the rest of the Legislature will share this sense of urgency in ensuring that their neighbors, friends, colleagues and family members can afford their prescriptions.
The cost of medications to patients is often much higher than the cost to their insurance company — for the same medicine on the same prescription. That’s because health insurance companies and pharmacy benefit managers negotiate significant rebates on the cost of medicine and do not share these savings with patients.
The average rebate on a branded drug is nearly 50%, meaning insured Sooners may be paying nearly twice what the insurer pays for their medications.
The excess amount paid by patients is going to the pharmacy benefit managers and insurance companies who, by the way, own each other.
The top three pharmacy benefit managers control 75% to 80% of the U.S. drug market and are driving up the list prices of drugs by demanding rebates on the back end.
Insurance companies falsely say they use these rebates to keep premiums down. The statistical impact of passing through these rebates to the patient would result in a less than 1% increase in premiums.
The current rebate practice is reverse insurance.
The sick are subsidizing the healthy — not how insurance is supposed to work. Why should the insurance company profit off my drug purchase, especially during the deductible period?
It’s becoming abundantly clear that this issue is being recognized nationwide.
Rebate pass-through legislation was passed last year in West Virginia and was proposed in 12 other states. It was also added to the Council of State Governments’ suggested state legislation list at its annual meeting in December.
We expect more concerned legislatures across the country to consider adding this protection for their fully insured citizens.
By helping patients live healthier lives now, we also help them stay healthy in the future. By decreasing barriers to treatment access, we are simultaneously helping curb the often-devastating effects of chronic disease and also lowering the cost of these comorbidities, which effectively saves patients — and the state — money.
On behalf of Oklahomans living with diabetes and in alliance with fellow leading patient advocacy groups, we call on Oklahoma legislators to vote to yes on SB 1324 and share the savings with patients to ensure a healthier Oklahoma for generations to come.
Kim Koleber is a Tulsa resident and long-time advocate and champion of those living with diabetes. Personally affected, Koleber’s daughter was diagnosed with Type 1 diabetes at age 3.
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A proposal before the Legislature would send prescription rebate pass-throughs on to the patient.
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