Drug Pricing

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Maryland Senate letter in opposition to to SB0357 expanding the authority of the Prescription Drug Affordability Board

Feb 4, 2025

While we share a commitment to addressing the high cost of prescription drugs, we have significant concerns with SB0357 that expands the authority of the Prescription Drug Affordability Board (PDAB). We believe it will not translate into lower drug costs for patients and may dampen future drug development. Access to and affordability of the latest drugs are especially critical for patients living with HIV, hepatitis, cancer, and rare diseases. People with HIV and hepatitis B rely on drug treatments that they must take for the rest of their lives, while people with hepatitis C can be cured of their disease in as little as 8 to 12 weeks. We also now have medications that prevent HIV.

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Oregon PDAB comments on HIV drug affordability, copay accumulators, and alternative funding programs

Dec 13, 2024

As the Oregon PDAB begins reviewing its initial list of prescription drugs, we believe that affordability reviews of HIV medications fail to fully account for the intricacies of the existing HIV safety net, which makes lifesaving HIV treatments affordable for most people. We also want to raise numerous factors in the global HIV drug ecosystem that would be difficult for a state to consider.  Finally, we reiterate our support for the proposed legislative policy recommendations that enhance transparency around insurers’ use of copay accumulators, maximizers, and the need to consider alternative funding programs.

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PACHA comments urging enforcement of ACA non-discriminatory regulations on HIV treatment

Dec 12, 2024

The HIV+Hepatitis Policy Institute again urges the Secretary to take administrative action to ensure that the ACA’s non-discrimination regulations are fully enforced. In the states where CCIIO has jurisdiction, it must investigate complaints and ensure plans are in compliance. In the other states, CMS should update tools to empower states to review plans as they are filed annually to ensure that HIV drugs included in national treatment guidelines are covered, and that HIV drugs are properly tiered. CMS regulations clarifying that these practices are presumptively discriminatory date were first promulgated in 2016, and further updated in 2022, but the tools CMS provides to review the plans do not yet provide adequate protections to ensure that people with HIV are not discouraged from enrollment. Finally, the HHS Office of Civil Rights should be brought to the table in this process to further assess bias and discriminatory review with regard to insurance plans and their coverage of HIV drugs.

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Substandard & discriminatory HIV medication plan design and coverage by Medica in Iowa

Nov 15, 2024

These benefit designs, which discourage enrollment by Iowans living with HIV, are plainly discriminatory.  We urge the Iowa Insurance Division, which reviews, approves, and regulates Marketplace plans in Iowa, to take immediate action against Medica for offering these substandard plans that violate the ACA and its implementing regulations.  We urge you to ensure that these violations are rectified before the new plan year begins.

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