Among Americans who take prescription drugs, a quarter struggle to afford their medication. For those who are in poor health or have low incomes, the portion is even higher. These days, the rising cost of everyday goods and services is forcing more people to face difficult decisions and ask themselves: How can I pay for utilities, the groceries, or the medicine that’s keeping me alive? Now imagine that someone offers you financial assistance for the express purpose of paying for your medicine—problem apparently solved. But in a cruel twist, your health insurer pockets that assistance, without counting it toward your annual deductible or out-of-pocket maximum. That’s why the HIV+Hepatitis Policy Institute, the Diabetes Leadership Council, and the Diabetes Patient Advocacy Coalition filed suit in federal court, challenging the Trump-era federal government rule that allows insurers and pharmacy benefit managers to carry out this harmful practice.
Biden administration misses big chance to reduce prescription drug costs
President Biden has repeatedly promised to make health care more affordable. And his administration has taken some important steps. But sadly, officials at the Centers for Medicare and Medicaid Services just passed up an opportunity to save patients millions at the pharmacy.
Rely on drugs? Read the fine print
Over the next few weeks, thousands will select insurance plans for 2022, whether on a state exchange or through their employer. A health plan’s fine print hardly makes for riveting reading. So most folks just focus on the monthly premium, make sure their doctor is covered, and ensure cost-sharing responsibilities are manageable. But that fine print is important, especially when it comes to how insurers treat co-pay assistance, or financial help that drug companies offer to patients to assist them with prescription drug out-of-pocket costs. [This opinion piece also appeared in The Lebanon Democrat, The Leader/Observer, Forest Hills/Rego Park Times, Long Island City/Astoria/Jackson Heights Journal, Greenpoint Star, and Brooklyn Downtown Star.]
Enforcement needed to ensure health-plan compliance with HIV preventive drug requirement
As we begin 2021, almost everyone with private health insurance will have free access to drugs that prevent HIV infection, known as pre-exposure prophylaxis, or PrEP. To start with, it is remarkable that such medications exist, and so important that health care coverage laws emphasize preventive services…
Three guiding principles for patient-centered decision-making in Washington for 2021
“Millions of patients most vulnerable to the effects of COVID-19 are not only feeling left behind in 2020, but are facing more intense health and economic challenges as policymakers and regulators make one poor policy decision after another.”…