Cost-sharing

71 patient groups comment on how nondiscrimination in healthcare rule can improve prescription drug access

The HIV+Hepatitis Policy Institute (HIV+Hep) and the Autoimmune Association, along with 69 other patient organizations, commented on how the Section 1557 nondiscrimination in healthcare proposed rule can be used to improve patient access to prescription drugs. In their comment letter, the patient groups expressed strong support for the “meaningful steps to improve upon current regulations to ensure that people are not discriminated against in healthcare. In several instances, you have proposed to restore protections that had been included in the past but later withdrawn. In other instances, you have provided further clarity on what constitutes discrimination. In any instance, we emphasize that the law and whatever is finalized in regulation must be strictly enforced.”

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Texas court decision on PrEP must not stand: Preventing HIV is a public health imperative

Preventive services covered by private insurance plans without cost- sharing, such as HIV testing, hepatitis B and C testing, and PrEP, are all critical and well-established public health preventive services that must continue. To single out PrEP, which are FDA approved drugs that effectively prevent HIV, and conclude that its coverage violates the religious freedom of certain individuals, is plain wrong, highly discriminatory, and impedes the public health of our nation.  PrEP is not just for gay men, but for anyone who may be at risk of HIV.

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Patient groups file suit to end policy that prohibits copay assistance from counting toward patients’ out-of-pocket spending

The HIV+Hepatitis Policy Insite, the Diabetes Leadership Council, and the Diabetes Patient Advocacy Coalition filed suit in the U.S. District Court for the District of Columbia challenging a federal rule that allows health insurers and pharmacy benefits managers to avoid counting drug manufacturer copay assistance toward patients’ out-of-pocket cost obligations. Due to increased deductibles and cost-sharing requirements, patients rely on copay assistance to help them afford their #Rx.

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105 Patient groups detail to FTC PBM practices that harm access and affordability of Drugs

Today, the HIV+Hepatitis Policy Institute (HIV+Hep) and the Autoimmune Association, along with 103 other organizations representing a broad range of patients across the country, submitted comments to the Federal Trade Commission (FTC) in response to a Request for Information (RFI) on the impact of pharmacy benefit manager (PBM) practices and the ability of patients to access and afford their prescription medications.

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Biden administration begins to address patient affordability of medications: but fails to ensure copay assistance counts as patient cost-sharing

The Biden administration released a proposed rule that will govern how private health plans must operate in 2023 and in doing so, took some steps to limit patient cost-sharing for prescription drugs. However, despite the urging from patient groups, they are not requiring insurers and pharmacy benefit managers (PBMs) to count copay assistance towards patient out-of-pocket cost-sharing and deductibles.

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