My Life Changed From Just Existing to Living

For Brittany, access to affordable medication was transformative—and she thanks PBMs for making it possible.

 

Brittany has many reasons to be thankful. At 29, she lives in a stylish apartment outside Washington DC, enjoys her job counseling people with mental illness and aspires to earn a college degree to take her career even further.

And more than anything, Brittany is thankful she has access to affordable medication that keeps her own mental health in check.

 

“Without my medication, there are days that I can’t get out of bed in the morning,” she said. “Having access to quality medication has been absolutely transformative.”

 

Brittany suffers from attention issues and bipolar disorder, which were a crippling force in her life for many years. Her medication would cost roughly $350 a month, a tall order for someone working and going to school. But thanks to her prescription drug benefit, an entire month of medication costs about the same as a cup of coffee.

 

“Having a pharmacy benefit manager negotiating on my behalf, I pay $5.”

 

Pharmacy benefit managers (PBMs) administer prescription drug plans for more than 266 million Americans with health insurance like Brittany, from Medicare beneficiaries to people insured through their employer. Over the course of a decade, PBMs will save consumers and health plan sponsors more than $1 trillion.

 

The advocacy of PBMs helps patients like Brittany stay healthy and maintain access to their prescription drugs. It makes a big difference for everyone who needs an advocate on their side.

 

For Americans like Brittany, having a PBM in their corner alleviates worry.

 

Pharmacy benefit managers (PBMs) administer prescription drug plans for more than 266 million Americans with health insurance – from those using Medicare to people insured through their employer. Through PBMs’ work, patients like Brittany receive reliable and affordable access to prescription medications they desperately need.

 

In Brittany’s case, she saves more than $4,100 a year on medication she needs to help her lead a healthier life, including prescription medications for her bipolar disorder – thanks to her pharmacy benefit manager.

 

PBMs use many tools to lower prescription drug costs. They encourage the use of generic medications; negotiate rebates from drug manufacturers; fight for discounts from pharmacies; manage the cost of expensive specialty medications; and work to reduce waste and medical errors.

 

PBMs lower the cost of prescription medication by 40% to 50%, saving payers and patients an average of $962 per person each year, according to the association. Put another way, for every $1 spent on PBMs, those same PBMs reduce costs by about $10.

 

“My life changed from just existing to living,” she said. “I was able to form meaningful relationships. I was able to keep jobs long-term and actually move up in companies because my true self was able to shine.”

 

‘A Beacon of Hope’: PBMs Offer Brittany Long-Sought Comfort

 

Brittany has been in treatment for the better part of a decade, but she remembers well what life was like before her medication.

 

“I can reflect on the times that I wasn’t on this regimen and my life was not easy,” she said. “I found that making friends, making connections, making meaningful relationships was very difficult.

 

Thanks to her pharmacy benefit manager (PBM), Brittany does not have to worry about getting her medication. Brittany has her prescriptions called in, picks them up in person, and the cost never varies. She knows she can rely on the medication that has made such a difference in her daily life.

 

“Having that drug benefit, it allows me to pursue my career, pursue my profession,” she said. “It also allows me to be a beacon of hope for other people.”

 

Brittany’s experience has fueled her interest in mental health as a career. She is currently working at a nonprofit that helps people overcome mental illness and substance abuse through peer counseling. By sharing her experiences, she helps others recover. Brittany is also in training as a social worker and plans to move into a college degree program immediately thereafter.

 

“I want to get into reentry, maybe working with youth who have been incarcerated and need to kind of get back out here and get things together, because the world can change,” she said

 

Brittany knows that PBMs negotiate with pharmacies, insurers and drug manufacturers and that consumers cannot always directly see the work that gets done to reduce prescription costs. But she has gotten a direct glimpse of the process at work.

 

“I got a letter in the mail from my pharmacy benefit manager saying that one of my medications was going up in price, but they were working to prevent that,” she said. “It was extremely comforting.”

 

As she put it, “I have actually received a letter saying, ‘Hey, somebody is advocating on your behalf!’”

Learn more about how PBMs are #OnYourRxSide, advocating for patients and keeping costs down.