February 6, 2025

Missouri Senate 
201 West Capitol Avenue
Jefferson, Missouri 65101

Dear Senator,

On behalf of 35,233 members and supporters of the Council of Citizens Against Government Waste (CCAGW) in Missouri, I urge you to reject S.B. 45, S.B. 372, S.B. 512, and similar legislation that would create unnecessary regulatory barriers that will undermine the effectiveness of pharmacy benefit managers (PBMs) in Missouri and increase prescription drug costs for patients.

PBMs save an average of $1,040 for patients by negotiating lower prices on behalf of large groups.  More than 275 million Americans who obtain health coverage from their employers, unions, state government plans, and other sponsors rely on PBMs to administer their prescription drug plans.  PBMs use various tools like rebates, pharmacy networks, drug utilization review, formularies, specialty pharmacies, mail-order, and audits to drive down drug costs, improve quality, increase patient medication adherence, and prevent fraud.

PBMs provide savings for patients by allowing a specialty pharmacy to ship a drug for a given patient offering home delivery of prescriptions at a lower cost.  Restricting this cost-saving practice takes choices away from patients and limit limits how employers and other plan sponsors can compensate their PBMs for their services.  The bills limit negotiations on behalf of patients and will lead to less competition in the healthcare marketplace, resulting in higher prices.

For the above reasons, I ask you to oppose S.B. 45, S.B. 372, S.B. 512, and similar legislation that would insert the government further into the healthcare system and result in higher costs and fewer choices for patients in Missouri.

Sincerely,
Tom Schatz
President, CCAGW