Here's a question worth asking anyone who promises to lower your drug costs: do you even know where the money goes right now? Because for most of the prescriptions filled in Louisiana, the honest answer is that no one outside the industry does.
That's by design. The Pharmacy Benefit Managers who sit between drug companies and patients negotiate the discounts, decide which medicines your plan covers, and set what you owe at the register, all behind a curtain almost nobody gets to look behind. A rebate gets negotiated on your medication, and whether a cent of it ever reaches you is anyone's guess. When a system is that opaque, it's usually opaque for a reason.
Which is what makes Washington's fixation on Most Favored Nation pricing so frustrating. That plan would tie our drug prices to what other countries pay, chasing manufacturer list prices while ignoring the murky middle where Louisiana families actually lose money. Worse, it would import the rationing and treatment limits those countries accept in exchange for their lower prices. It's a headline, not a solution.
You can't fix what you can't see. The first real reform is forcing daylight onto how PBMs operate, so the savings meant for patients stop vanishing along the way.
Congress is home this month, and an election is coming. I'd ask Louisiana's delegation to choose substance over slogans: demand transparency from the middlemen, and leave the foreign price controls where they belong.
Cason Key
