Prescription Drugs

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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40 patient groups urge HHS to improve drug affordability through standard benefit plans

The HIV+Hepatitis Policy Institute (HIV+Hep) and American Autoimmune Related Diseases Association (AARDA), along  with 38 other patient  organizations, filed comments earlier this week with the U.S. Department of Health and Human Services (HHS) addressed to Secretary Xavier Becerra that urge HHS to improve the affordability of prescription drugs for patients in the private insurance market through Standard Benefit Plans.

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Biden administration passes on protecting patient affordability of medications

“We are deeply disappointed that CMS passed on addressing the issue of copay assistance for prescription drugs and requiring insurers and pharmacy benefit managers (PBMs) to count assistance towards patient out-of-pocket cost-sharing and deductibles,” commented Carl Schmid, executive director of the HIV+Hepatitis Policy Institute.

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Biden administration pulls last-minute Trump Medicare drug demo plan

Washington DC… In a victory for patients who depend on Medicare Part D for their medications, the Biden administration has pulled a demonstration project that would have allowed participating Medicare plans in 2022 to not cover all drugs in certain classes and only one drug per class in all others. The proposal that was pulled was announced literally in the final hours of the Trump administration.

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