Cornhusker State News

In Nebraska, we value honesty, hard work, and looking out for each other when times get tough. When it comes to prescription drugs, though, Nebraskan families—farmers in North Platte, teachers in Hastings, and seniors in Lincoln—are getting squeezed. And despite what you might hear on TV, it’s not the so-called “middlemen” who are bleeding us dry, but Big Pharma itself, lobbying hard to keep prices high and choices limited.

In Nebraska, nearly 1 in 3 residents have skipped or rationed medication due to cost—that’s over 600,000 Nebraskans forgoing drugs their doctors prescribe, according to the Gallup-Sharecare Well-Being Index and AARP. Every month, families open surprise bills at the pharmacy counter. Even with insurance, the average Nebraskan paid over $1,200 out of pocket on prescriptions in 2022. Meanwhile, insulin, lifesaving for Nebraska’s nearly 166,000 diabetics, still retails for $275 per vial, even though it can be made for less than $10, according to the American Diabetes Association.

Why? Because Big Pharma sets the prices. While they pour over $374 million a year into federal lobbying—more than the oil, defense, and tech industries—they try to shift the blame onto Pharmacy Benefit Managers (PBMs), the only groups negotiating discounts on our behalf.

When PBMs negotiate, Nebraska’s Medicaid program saves over $175 million annually according to a Nebraska Medicaid Annual Report, 2023. PBMs also support hospitals across Nebraska—like Bryan Health in Lincoln—giving our rural clinics access to lower-cost medicines that are a lifeline in small towns.

What Big Pharma really fears is integrated care, where your insurer, PBM, and hospital work together as a team. Studies show these integrated models have 15–20% lower drug costs, better chronic disease outcomes, and fewer ER visits. That’s why drug companies and their DC lobbyists are pouring millions into slick ads, hoping to break up the only system that threatens their price monopoly.

If PBMs were wiped out tomorrow, Big Pharma could charge whatever they want—just look at the 40% price hikes we saw on common medicines when PBM oversight was weakened in other states.

Nebraskans know better than to trust Wall Street boardrooms or DC lobbyists. We need PBMs and common-sense conservative oversight to rein in costs, and to keep the focus on patients, not corporate profits.

So when a multimillion-dollar Pharma ad blames the “middlemen,” remember who’s paying for it. In Nebraska, we fight for our families, our Main Streets, and our right to affordable prescriptions—because nobody should have to choose between food and medicine. With the facts on our side, let’s demand reforms that put Nebraskans first and keep Big Pharma honest.

Hallie McAnally is a political activist in Nebraska.