Patient Group Letter to Sec. Kennedy on ensuring patient access and affordability under TrumpRx

The Honorable Robert F. Kennedy Jr.
Secretary
U.S. Department of Health and Human Services
200 Independence Avenue SW
Washington, DC 20201

Dear Secretary Kennedy,

On behalf of the undersigned organizations, we are encouraged by the Administration’s commitment to lower prescription drug costs, including the announcement of the TrumpRx platform. Together we represent hundreds of millions of Americans with serious and chronic diseases who rely on regular access to medications to maintain their health. Two core issues our patients routinely face are high out-of-pocket costs and a lack of transparency about the costs and coverage requirements of their drugs. Direct-to-consumer programs like TrumpRx are a step in the right direction towards addressing those issues and we are hopeful that by eliminating bureaucratic hurdles for patients it could truly improve access, affordability, and transparency in the healthcare system.

We want to ensure these benefits reach as many patients as possible and would like to work with you to implement this program. While it may be a great option for some patients, unless it integrates with existing insurance frameworks, it may only help a fraction of the patients who could ultimately benefit, such as the uninsured. For high-cost drugs that our patients rely on to remain healthy, even a heavily discounted price is still unaffordable. To be broadly successful in helping reduce Americans’ out-of-pocket costs, we strongly urge the Administration to provide information to consumers on how this program will integrate with commercial, employer-sponsored, and Medicare plans.

In order to improve the success of the platform we believe there are several policies the Administration needs to clarify: 

1. From a patient education standpoint, patients might utilize the TrumpRx platform with the assumption that their out-of-pocket costs will count towards their insurance benefits. We strongly encourage the Administration to disclose the parameters of the direct-to-consumer program in clear language on the TrumpRx platform, and to direct health insurance plans to educate plan enrollees, to ensure patients understand how these purchases do or do not interact with their insurance benefits.
2. Consumers who visit TrumpRx may have varying types of health insurance coverage including, but not limited to, Medicare, commercial plans, and employer-sponsored coverage. HHS and relevant agencies must issue guidance on the extent to which prescription drugs purchased via TrumpRx will count towards an enrollee’s deductibles and out-of-pocket maximums.
3. At a minimum, HHS can strongly encourage health insurance companies and PBMs to voluntarily recognize TrumpRx expenses as counting towards deductibles and out-of-pocket To help promote accountability, HHS could considerpublishing periodic updates on insurer participation to promote transparency for patients across the marketplace.

Once again, we strongly support the Administration’s commitment to reduce administrative and price frictions for patients and we stand ready to work with you to make these programs successful for all  Americans.

Thank you for your leadership and commitment to improving access and affordability in prescription drug coverage. We would very much appreciate the opportunity to meet with you or your staff at the earliest convenience in order to help ensure the program’s success.

Please contact Anna Hyde, Vice President of Advocacy and Access at the Arthritis Foundation at ahyde@arthritis.org, or Carl Schmid, the Executive Director of the HIV+Hepatitis Policy Institute at cschmid@hivhep.org with questions.

Sincerely,
AiArthritis
Aimed Alliance
Alliance for Headache Disorders Advocacy
ALS Association
Arthritis Foundation
Autoimmune Association
CA Chronic Care Coalition
Chronic Care Policy Alliance
Coalition of Skin Diseases
Dravet Syndrome Foundation
HIV+Hepatitis Policy Institute
ICAN, International Cancer Advocacy Network
Immune Deficiency Foundation
International Myeloma Foundation
Lupus Foundation of America
National Consumers League
National Health Council
NV Chronic Care Coalition
Pacific Northwest Bleeding Disorders
Spondylitis Association of America

cc:          Dr. Mehmet Oz, Administrator, CMS
Chris Klomp , Director of Medicare and Deputy Administrator, CMS
Theo Merket, Domestic Policy Council, The White House