Three Years Since Court Victory & Prescription Drug Copay Assistance Still Not Counting for Patients
At a time when the American people are focused on the affordability crisis and concerned about how much they pay for their prescription medications, the federal government can easily reduce their costs by complying with the court order and telling insurers they must count copay assistance towards patient cost-sharing. Instead, they are siding with the big insurers and drug middlemen, increasing their profits at the expense of patients who are struggling to afford their medications.
HIV+Hep Praises DC, Massachusetts, and Delaware for Protecting PrEP Access
DC, Massachusetts, and Delaware have joined a growing number of states and jurisdictions acting to guarantee insurance coverage of highly effective HIV prevention medications known as PrEP without cost-sharing or prior authorization. These laws not only enshrine the coverage requirements into state law, but clarify that the full range of PrEP options, including newer long-acting injectables, must be covered. We thank Governor Meyer, Governor Healey, Mayor Bowser, and the lawmakers who championed these protections that will reduce access barriers, and we urge other states to follow their lead.
Mississippi insurer adds PrEP coverage after complaint, but gaps remain
We are pleased that Blue Cross Blue Shield of Mississippi has taken steps to comply with federal preventive coverage requirements by adding these two PrEP drugs. The people of Mississippi deserve the same benefits of innovative HIV prevention tools that other people across the country have access to. But by excluding other long-acting medications, which are recommended in national HIV treatment and prevention guidelines, Mississippians are still not able to access these highly effective drugs that improve patient adherence.
House Appropriations calls on CMS to ensure copay assistance counts toward out-of-pocket limits
For years patients have seen manufacturer assistance diverted away from their deductibles and out‑of‑pocket maximums, increasing their costs and forcing impossible choices. We thank the subcommittee for urging CMS to act and call on the agency to promptly issue clear, enforceable guidance so patients actually receive the benefit of assistance meant for them.