PBMs

Support for D.C.’s “Copay Accumulator Amendment Act of 2021”

HIV+Hep strongly supports the “Copay Accumulator Amendment Act of 2021” (Bill 24-0557) introduced by Chairman Gray and four councilmembers.  It simply requires that the copay assistance beneficiaries receive count towards their out-of-pocket obligation.  By passing this law, DC will join 14 other states (Arkansas, Arizona, Connecticut, Georgia, Illinois, Kentucky, Louisiana, Maine, Oklahoma, North Carolina, Tennessee, Washington, West Virginia, and Virginia) and Puerto Rico in protecting consumers by assuring their copay assistance will count towards cost-sharing obligations.

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105 groups comment on the role of PBMs on patient access and affordability of prescription drugs

We, the undersigned 105 organizations, on behalf of millions of patients and Americans who live with complex conditions such as HIV, autoimmune diseases, cancer, diabetes, kidney disease, lupus, hemophilia, mental illness, and hepatitis write in response to the Federal Trade Commission (FTC) request for public comment on the impact of pharmacy benefit manager (PBM) practices on consumers.  Specifically, we offer comments on how PBMs impact the health and well-being of patients who receive their health coverage through the private insurance market.  While most people think insurers make the majority of decisions regarding health coverage and affordability, when it comes to prescription drugs, it is the PBMs that drive much of the decisions as to what medications a beneficiary can access and how much they pay for them.  We commend the FTC for its leadership to investigate the impact that PBM practices have on the patient communities we serve and believe this represents a critical step forward to improving patient access and affordability to necessary medications.

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CMS responds to request for information regarding reporting on pharmacy benefits and prescription drug costs

On behalf of the Centers for Medicare & Medicaid Services (CMS), thank you for the letter regarding the Request for Information (RFI) Regarding Reporting on Pharmacy Benefits and Prescription Drug Costs1. The 58 organizations that signed this correspondence are the voice for many individuals who rely on affordable prescription drugs to treat their health conditions and prevent others, and we appreciate hearing from you on this important issue.

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Patient groups comment letter on 2023 health plan proposed rule

We, the undersigned 51 organizations, on behalf of millions of patients and American consumers who live with complex conditions such as HIV, autoimmune diseases, cancer, diabetes, lupus, hemophilia, mental illness, and hepatitis, write to comment on the Notice of Benefits and Payment Parameters for 2023 Proposed Rule. The patients we represent appreciate all you are doing to make healthcare more accessible and affordable for beneficiaries. While there are several components of the proposed rule that many of us will comment on elsewhere, this letter focuses on those issues that impact access and affordability of prescription drugs.

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