Almost three million people in Louisiana suffer from at least one chronic illness. Louisiana lawmakers can implement a simple fix to lower the cost of prescription drugs.
In 2018, hospitals, health insurers, pharmacy benefit managers, the government, and others received close to a 50% profit of what was spent on brand medicines -- all we’re asking for is these profits to be shared with the consumer.
I, like many people, am increasingly shocked at the price we’re expected to pay when we pick up our prescriptions at the pharmacy counter.
Health insurers and their entities known as pharmacy benefit managers, or PBMs, have implemented tricky practices that benefit their bottom lines and leave patients with additional out-of-pocket costs.
One of these tricks is a new policy known as a copay accumulator and is unfortunately found in all plans available in Louisiana right now.
This policy prohibits patient assistance tools, like prescription drug coupons or copay cards, from applying towards a patient's annual deductible and out-of-pocket maximum amount – forcing consumers to pay even more as they fight to reach their deductible.
For some patients, the extra out-of-pocket costs due to a copay accumulator policy make their medications unaffordable. These patients may stop treatment or alter doses to make their medication last longer.
Patients may also be forced to choose between their medication and paying for other basic needs such as food, housing, and utilities.
It’s time to implement legislation that will protect the patient.
— Andrew Baer, Baton Rouge