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PBM Reform Form Letter for Elected Representatives

This editable form letter is designed to help you easily communicate your concerns about restrictive Pharmacy Benefit Manager (PBM) practices to your local, state, and federal representatives. By using this template, you can quickly draft a professional letter that advocates for PBM reform, ensuring that patients have access to essential GLP-1 medications as per FDA guidelines. To make effective use of this letter, simply download the document (or use copy/paste), fill in your personal information and details specific to your representative, and personalize any sections to reflect your unique perspective. Once completed, send the letter via email or traditional mail to your representative's office. Sharing this resource with others can also amplify your advocacy efforts.


Find your rep’s contact info here:


If you find this resource helpful, please consider sharing it into any groups, forums, or threads you are a part of.


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.docx
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Generic Form Letter to a Representative


[Your Name]

[Your Address]

[City, State, ZIP Code]

[Email Address]

[Date]


[Representative’s Name]

[Representative’s Office Address]

[City, State, ZIP Code]


Dear [Representative’s Name],


I am writing to express my concern regarding the recent practices of Pharmacy Benefit Managers (PBMs) that restrict access to essential medications for patients who meet FDA-approved guidelines. As your constituent, I urge you to support and advocate for PBM reform to ensure that patients can receive the medications they need without undue barriers.


The FDA has established clear criteria for prescribing GLP-1 medications for weight loss, including a BMI of 30 or higher, or a BMI of 27 with at least one weight-related comorbidity. These guidelines are designed to ensure that individuals with obesity and related health conditions can access life-changing treatments. However, PBMs such as Express Scripts and Blue Cross Blue Shield of Michigan have implemented more restrictive coverage criteria that go beyond FDA guidelines, potentially disqualifying many patients who would otherwise be eligible.


The new PBM requirements often include higher BMI thresholds, mandatory enrollment in specific health programs, and stringent prior authorization processes. These practices create significant access barriers, increase the burden on patients, and can lead to interruptions in necessary treatments. Additionally, moves to restrict the prescribing of branded GLP-1 medications through telehealth services further limit patient access, particularly for those in remote or underserved areas.


I respectfully request that you consider supporting legislation that addresses these issues and protects patient access to medications. Recent legislation in Oklahoma, which seeks to put some restrictions on PBMs, serves as a model that other states can follow. Ensuring that PBMs adhere to FDA guidelines and do not implement arbitrary restrictions will help improve health outcomes for countless individuals struggling with obesity and related conditions.


I urge you to take action on this important issue and advocate for PBM reform that prioritizes patient health and well-being. Thank you for your attention to this matter and for your continued service to our community.


Sincerely,


[Your Name]


1,166 views2 comments

2 Comments


cindyreg4
cindyreg4
Jun 15

Sent and also posted info in Reddit and FB

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Sending my letter this weekend! Thanks for doing this.

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