LET’S START with something that we can all agree with: the rising cost of health care in Massachusetts and the entire country is a crisis that threatens not only the viability of our small and large businesses, but our economy as a whole. It’s a problem that cannot continue if we’re to prosper and provide health care to everyone in the Commonwealth.

Prescription drug costs, especially in an aging society, represent an increasing percentage of our total health care spending. Successfully containing these costs requires a rigorous focus on the primary factors driving the increase which, in this case, is not difficult to understand. According to research by AARP’s Public Policy Institute, the prices of the top 25 Medicare Part D drugs has more than tripled since they entered the market. The prices of new drugs have gone up an average of $2,115 per year in 2008 to $180,000 in 2021. These were price increases established by Big Pharma alone in order to pad the pockets of executives and shareholders.

What is the pharmaceutical industry’s response to all this? To blame everyone but themselves. All over the country Big Pharma is challenging laws in Federal court that seek to reign in rising drug costs and fortunately, losing. So now Pharma is simply trying to move the battle to a different playing field.

In Boston and down in Washington DC, Big Pharma has invented a new boogey man: pharmacy benefit managers, or PBMs. They want you to believe that PBMs are evil “middlemen” primarily responsible for medication costs that are putting a strain on our small businesses and the pocket books of working families.

What are PBMs and why the finger pointing? PBMs are responsible for managing prescription drug plans on behalf of health plans. They negotiate with pharmaceutical companies and pharmacy networks to lower costs on prescription drugs. PBMs force manufacturers to compete with one another over price, thus lowering costs for prescription drugs on behalf of plans.

Drug manufacturers raise the prices of drugs to increase profits. PBMs negotiate and leverage competition to drive down costs on behalf of health plans and employers.

Now, who should we really be holding accountable for rising drug costs?

Jack Lank has been president & CEO of The United Regional Chamber of Commerce since 2006. The United Regional Chamber of Commerce is a member of Save Our Benefits MA. He is a past president and current board member of the Massachusetts Association of Chamber of Commerce Executives.