The high cost of prescription drugs can be devastating for many Americans, including some of the more than 200,000 Mainers living with mental illness.

Every day, some individuals must choose between a medicine that can help improve their lives or buying groceries and paying rent. The health care system isn’t working for people in need of life-saving treatment. Fortunately, legislation being considered by state lawmakers promises to help reshape how patients access and afford prescription medications.

This type of proposal, nationally referred to as “Share the Savings,” ensures that negotiated savings directly benefit patients. This change holds immense promise for individuals navigating the complex landscape of mental health treatments.

Each year, substantial discounts and rebates are negotiated by pharmacy benefit managers (PBMs), health plans and other payers. However, these discounts are not being passed through to the patient who is receiving the drug. Instead, they are retained by the health plan or the PBM. This is unacceptable and unfair.

In Maine, a bill – L.D. 1165 – aims to mandate that health insurance companies and PBMs share negotiated prescription drug savings directly with patients at the pharmacy counter.

The use by insurance companies of deductibles and co-insurance for prescription medicines has surged over the past decade, creating significant affordability challenges for those seeking mental health treatment. L.D. 1165 emerges in response to this issue, aiming to lower consumer out-of-pocket spending by directing negotiated rebates and discounts directly at the point of sale.

Long-standing inequities in medication access and adherence contribute to health disparities, affecting underserved populations more severely. “Share the Savings” legislation offers a tangible solution by ensuring patients pay less out-of-pocket at the pharmacy counter, ultimately enhancing access, reducing avoidable health care use and costs, and decreasing mortality rates.

High out-of-pocket costs often forces individuals to ration or abandon their prescriptions, resulting in adverse outcomes and increased health care costs. L.D. 1165 acknowledges this critical issue and proposes a solution: sharing negotiated rebates with the individuals who need them the most at their local pharmacy.

Contrary to concerns about the impact on health plan premiums, studies indicate that sharing prescription drug rebates with individuals has a minimal effect. The first state to pass this legislation, West Virginia, recently reviewed its insurance rate filings, which indicated that plans are passing through drug rebates to patients at the pharmacy counter and that premium increases in West Virginia are in line with national premium increases for 2023, which demonstrates that sharing 100% of the rebates with patients does not significantly raise premiums.

L.D. 1165 is not just legislation, it’s a potential lifeline for individuals navigating mental health challenges. We thank Rep. Margaret Craven, D-Lewiston, for sponsoring and supporting this legislation and helping her constituents and our families and friends throughout Maine access the drugs and therapies they need at the lower cost they deserve.

Again, NAMI Maine proudly stands behind this bill as it ensures that negotiated savings reach the pharmacy counter, offering a transformative solution for Maine’s mental and overall health care landscape.

Support of L.D. 1165 is not just an advocacy choice; it’s a commitment to a future where mental health treatment is accessible and affordable for all individuals in Maine. We ask the Legislature and Health Coverage, Insurance and Financial Services Committee members to pass this legislation and mandate that PBMs and insurers finally share their savings with our patients.

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