The HIV+Hepatitis Policy Institute submitted comments recommending that the 2025 Draft Letter to Issuers in the Federal-facilitated Exchange include a reminder to issuers that copay assistance must be counted for all but brand name drugs with a generic equivalent, plans be flagged for adverse tiering when all or a majority of drugs to treat a certain condition are on the highest tiers, CMS takes a more proactive role in enforcement action against insurers that violate the law, and CCIIO fully reviews plans for benefit designs that discriminate against certain individuals.
Given the importance of medications to the health and well-being of people living with and at risk of HIV, people with hepatitis B & C, and their growing reliance on Medicare for prescription drugs, we are keenly interested in the implementation of the Medicare Drug Price Negotiation Program that CMS is setting up as required by the Inflation Reduction Act (IRA).
We, the undersigned 46 organizations, on behalf of millions of American patients who live with complex, chronic health conditions such as HIV, autoimmune diseases, cancer, diabetes, lupus, multiple sclerosis, and hepatitis, are pleased that your committee and Congress are focused on advancing policies and measures that improve prescription drug affordability and access for the American people. We believe there are clear actions that Congress can take right now to help patients access, afford, and adhere to the medications they need to stay healthy. However, several proposals on the table would create great challenges for those we serve and have negative implications for vulnerable communities and future treatment innovations.
Comments in response to request for information re: reporting on pharmacy benefits and prescription drug costs
We, the undersigned 58 organizations, on behalf of millions of patients and American consumers who live with complex conditions such as HIV, autoimmune diseases, cancer, diabetes, lupus, multiple sclerosis, and hepatitis, write in response to the Request for Information Regarding Reporting on Pharmacy Benefits and Prescription Drug Costs. The patients we represent rely on prescription drugs to treat their health conditions and prevent others. We are pleased that the Biden administration is moving forward with the requirement that insurance plans must report on various data points associated with prescription drug spending. We believe with this greater understanding and transparency of prescription drug costs, you can better implement policies and measures that increase competition, improve prescription drug affordability and access for the American people.
The HIV+Hepatitis Policy Institute strongly supports The PBM Accountability Study Act (HR 1829), which would require the Government Accountability Office to provide a comprehensive report to Congress on the ways in which PBMs influence the pricing of pharmaceuticals, impede competition, use rebates and also provide recommendations on ways to lower prescription drug costs.