Managing a household's prescriptions, doctor visits and insurance appeals shouldn’t feel like a second job. But for my family, it is a daily reality made worse by pharmacy benefit managers (PBMs).

Congress took a step in the right direction with recent PBM reform legislation, but the job is far from finished. Families will not see true relief until we change how PBMs operate. Right now, these middlemen may pocket the steep discounts they negotiate with drug manufacturers instead of passing the savings on to consumers. To make matters worse, severe corporate consolidation means the same conglomerates often own the insurer, the PBM and the pharmacy chain. This leaves patients with fewer choices and zero leverage.

Some politicians point to “Most Favored Nation” pricing as a silver bullet, but copying foreign price levels will not help American patients. Those international prices come with major trade-offs, including delayed access to critical care and restricted treatment options. Furthermore, freezing prices threatens the vital pipeline of medical innovation. The investment needed to discover future cures depends on pharmaceutical companies having the resources to fund risky research.

I feel true healthcare reform must focus on breaking up PBM monopolies and bringing transparency to the pharmacy counter — not importing foreign price controls that compromise American care.

Jeff Smith,

Butler City