I Rely on My Anxiety Medication

For Santiago, anti-anxiety medication helps him feel confident and safe—and he’s glad to have a PBM safeguarding his access.

 

Santiago was in college when his battle with anxiety began.

 

“I’ve had panic attacks before where it was difficult to get out of bed,” he said. “The idea of having another is crippling.”

 

Today, the 28-year-old no longer has that fear daily. Thanks to pharmacy benefit managers (PBMs), Santiago receives reliable access to medications that allow him to live and work without succumbing to symptoms of his anxiety. “I rely on my anxiety medication for two reasons: to regulate my everyday mood and to control panic attacks,” he said. “Without my medication, life would be a daily struggle. It gives me a sense of confidence and security and I wouldn’t want to be without it.”

 

PBMs are essential to bringing equity into the healthcare landscape for patients like Santiago. PBMs encourage the use of generic medications; negotiate rebates from drug manufacturers; fight for discounts from pharmacies; manage patient drug utilization; process prescription drug claims; manage the cost of expensive specialty medications; administer home delivery of medications; work to reduce waste and medical errors; and develop pharmacy networks for health plan sponsors – all of which help to decrease costs while increasing access for prescription medications for millions of Americans.

 

The Impact of Anxiety Disorders in the U.S., and How PBMs Help Provide Care

 

Almost one in five Americans suffer from anxiety disorders – or more than 40 million U.S. adults ages 18 and older – according to the Anxiety and Depression Association of America. These include Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder and more. Yet only about 37% receive treatment, according to the association.

 

As is the case with Santiago, proper medications are often effective ways of treating anxiety and other mental health disorders. Prescriptions for anti-anxiety medication increased dramatically after the pandemic hit, radically changing the everyday routine in schools, workplaces and homes across America. The America’s State of Mind report, released by Express Scripts in 2020, showed that anti-anxiety prescriptions increased 34% between February and March of that year.

 

But in order to help people, medication has to be accessible and affordable. Pharmacy benefit managers (PBMs) work on behalf of people like Santiago to keep prices in check and to ensure patients maintain access to the medicine they depend on for healthy living.

 

“I think pharmacy benefit managers give patients like me a huge level of comfort by ensuring that our drugs are both accessible and affordable,” Santiago said. “Every time I go to the pharmacy, I know that my medication is gonna be available.”

 

New Research Reinforces the Value of PBMs

 

A new study by the National Bureau of Economic Research called The Value of Pharmacy Benefit Management shows that PBMs create more than $145 billion in annual value. Without PBMs, the study found, employers, labor unions, and other health plan sponsors would lose out on $58 billion in value each year.

 

Pharmacy benefit managers, better known as PBMs, administer prescription drug plans for more than 266 million Americans with health insurance from those insured through an employer to people using Medicare. PBMs lower the cost of prescription medication by 40% to 50%, according to the study. In total, PBMs save payers and patients an average of $962 per person each year.

 

The result is far better health outcomes for millions of Americans.

 

“The value to society includes not only consumer savings … but the values of better drug utilization, an increased pace of drug development, and government savings,” wrote Casey Mulligan, the University of Chicago economics professor who authored the paper.

 

JC Scott, president and CEO at the PCMA, praised Mulligan’s model, research, and conclusions. “The first-of-its-kind quantitative model and paper mathematically shows that PBMs are a cost-reducing force in our health care system,” Scott said in a statement. “It’s time, once and for all, to put to bed false assertions about PBMs and recognize the factual truth: PBMs create value for health care payers and patients, leading to significant cost savings and healthier outcomes for patients.”

 

Like many patients, Santiago is not directly involved in debates over prescription drug policy, but he is affected by those policies every single day. Santiago describes that effect in dramatic terms.

 

“I think the people behind the scenes, who are kind of making it affordable and giving that level of comfort for the patient, is huge,” he said. “I mean, without it, it would be a completely different conversation about what we’re paying and what we’re expecting every time we go to the pharmacy.”

 

To see how PBMs are #OnYourRxSide, watch Santiago’s story here.