Rich Pezzillo is the executive director of the New England Hemophilia Association.

The rising cost of medications is becoming a burden for Granite Staters who are paying more out-of-pocket than ever before. If real policy reform is not passed in Congress, this problem will only intensify.

Congress can help this year, starting with the regulation of pharmacy benefit managers (PBMs).

It’s a known fact that seniors and patients with multiple chronic conditions pay more for their prescriptions than others. Over the past decade, the average out-of-pocket spending for patients has increased by nearly 58% in the United States. Patients with hemophilia are more likely to have another chronic disease, and those with two or more chronic conditions will spend five times more out-of-pocket than other patients. And patients with three or more chronic conditions will pay ten times more.

Currently, tens of millions of patients across the country suffer from one or more chronic illnesses. There are around 20,000 hemophilia patients and approximately 1.4 million Americans live with another bleeding disorder called Von Willebrand Disease (vWD).

Affordable and accessible medicines are vital for patients with chronic illnesses to lead long and productive lives. At the New England Hemophilia Association (NEHA), we represent each patient with a bleeding disorder who relies on these affordable and accessible medicines.

PBMs play a significant role in our healthcare system, they should be helping to prevent unnecessary price increases and keep patient out-of-pocket costs for medications down. However, PBMs have identified ways to profit by artificially increasing the prices of these life-saving medicines through bad-faith business practices.

Despite recent efforts to appear more transparent, PBMs have been taking advantage of our drug pricing system and identifying new ways to profit for years. Unless Congress steps in, we expect this to continue.

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PBMs will likely continue prioritizing profits over patients by not passing on negotiated drug rebates from drug manufacturers to patients. They will continue to steer patients to preferred medicines (those that will bring in more money for the PBMs) rather than the drugs their doctors prescribe. They will continue to increase out-of-pocket costs, leading to poorer medication adherence and negative health outcomes.

Every industry affected by increasing prescription medicine costs has started to speak out for change. Congress is starting to listen. Recent legislation aiming to address rebate pass-through medicines and “de-link” the price of medicines from PBM profits will benefit patients, businesses, state employees, and others facing high out-of-pocket costs.

Congress only has a few more legislative days to pass these reforms and help give patients the advantage over PBMs.

NEHA is calling for our New Hampshire leaders, Congress, and all presidential hopefuls to prioritize PBM reform and give Granite Staters the gift of affordable medicine in the new year.