Insurers

Alternative funding programs: The patient pays the price

Alternative funding programs: The patient pays the price

Kevin Herwig discussed alternative funding programs at the National Intellectual Property Rights Coordination’s Pharmaceutical Symposium, highlighting the harms of these schemes which delay or block access to life-saving drugs, and often try to force patients to obtain life-saving medications through illegal importation. He urged government regulators to take action to enforce the law, investigate AFP business practices, and close the loopholes that enable them to operate.

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Prescription drug formularies, consumer protections, and state enforcement: Focus on HIV treatment & prevention

Prescription drug formularies, consumer protections, and state enforcement: Focus on HIV treatment & prevention

NAIC consumer representative Carl Schmid spoke at the Rx Working Group to describe how insurers continue to place HIV drugs on high-cost tiers and are not covering required treatment and PrEP drugs, and how regulators must protect patients by fully reviewing plan drug coverage and tier placement, responding to patient complaints, and ensuring $0 patient costs for preventive services.

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Diversion of patient copay assistance by insurers, PBMs & third-party vendors

Diversion of patient copay assistance by insurers, PBMs & third-party vendors

Speaking to the NAIC Prescription Drug Working Group, Carl Schmid described how insurers, PBMs, and 3rd party vendors harm patients by not counting manufacturer copay assistance toward out-of-pocket costs as required under the ACA; which states have banned copay accumulators; and efforts to enforce the Court ruling that requires all copay assistance be counted for patients.

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