- Press Statement - New Insurer Perspectives Highlight Considerable Patient Challenges Anticipated from Prescription Drug Affordability Boards
- White Paper - Health Plans Predict: Implementing Upper Payment Limits May Alter Formularies and Benefit Design But Won’t Reduce Patient Costs
- Avalere Insights Blog - Research Explores Health Plan Perceptions of PDABs and UPLs
- PDAB Overview Infographic – Prescription Drug Affordability Boards: Promise ≠ Reality
- PPT Overview – Insurer Perspectives on PDABs
- OpEd - Boulder Daily Camera: Prescription Drug Affordability Board Might Not Deliver Savings to Patients
State boards of unelected bureaucrats are poised to have a devastating impact on patient access and affordability.
Right now, the state of Colorado is actively trying to lower out-of-pocket costs on prescription medications for patients – an important and admirable goal. And Colorado is not alone. However, the legislature has moved forward with a poorly designed plan despite the repeated warnings of rare and chronic disease patients: the Prescription Drug Board will limit access to critical medicines.
The Prescription Drug Board will allow a group of unelected bureaucrats to set reimbursement limits on medications. While policymakers argue that this will create savings for patients, they cannot guarantee that patients will actually see savings at the pharmacy counter or, even more grimly, continue to enjoy widespread medication access. It is more likely that any reduction in cost will go to health insurance plans who will keep any difference as profit rather than passing them on to the patients they cover.
Further, the Board’s power to create upper limits on how much insurers reimburse for drugs in the state could prevent patients from accessing their medicines. If a hospital or pharmacy cannot obtain a medication at the reimbursement rate the Board has set, then they will not acquire and sell it, sell it for a loss, or find a way to cover the added cost including charging the patient the difference. This will hit people living with rare and chronic diseases the hardest.
Join with us to highlight the consequences of allowing unelected bureaucrats to determine who gets their medicines and who doesn't.
