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 In several instances, you have proposed to restore protections that had been included in the past but later withdrawn.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.”
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.
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.
Biden administration takes big step in making drugs affordable for patients: Also strengthens nondiscrimination protections
In reaction to the Biden administration’s announcement today that insurers on the federal exchange must offer standard plans, which for the most part use reasonable copay limits for prescription drugs, Carl Schmid, executive director, HIV+Hepatitis Policy Institute (HIV+Hep), issued the following statement: “This is a huge win for patients. Insurers have made it almost impossible for patients to afford their medications by first requiring them to meet a high deductible and then charging high co-insurance, which is a percentage of the list price of the drug. By limiting patient copays and keeping more drugs outside of the deductible, patients will be better able to afford their medications. We only wish the Biden administration would have applied these principles to more metal levels and drug tiers, but this provides better options for people who rely on 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.