Prescription drugs are regularly in the news these days, whether it’s a close look at the cost of prescription drugs or a high-profile state ballot initiative. That’s because access to prescription drugs is critically important to millions of individuals and families nationwide, but high costs and coverage limits can put life saving drugs beyond consumers’ reach.
At today’s National Association of Insurance Commissioner’s (NAIC) national meeting, the consumer representatives to the NAIC released a report on state and federal regulatory options for promoting access to prescription drugs.The report, Promoting Access to Affordable Prescription Drugs: Policy Analysis and Consumer Recommendations for State Policymakers, Consumer Advocates, and Health Care Stakeholders, provides a series of recommendations to assist regulators, lawmakers, and the NAIC on ways to promote access, affordability, nondiscrimination, transparency, and meaningful oversight of prescription drug coverage. The report includes examples of existing state and federal approaches to addressing these issues as well as recommendations for consumer-protective policies to be considered by state and federal policymakers.
The report, made possible by a generous grant from the Robert Wood Johnson Foundation, is released as regulators consider changes to the NAIC Model Act that governs prescription drug benefits in health insurance coverage. Specific topics in the report address drug cost-sharing, adverse tiering, mid-year formulary changes, data collection and analysis, and value-based pricing, among many others. Key recommendations include limits on the number of drug tiers that insurers can use; limits on consumer cost-sharing by, for instance, prohibiting coinsurance for prescription drugs; and the adoption of standardized plans with meaningful cost-sharing limits to mitigate the effect of adverse tiering; among many others.
As an NAIC consumer representative, I’ll be attending the national meeting this week and will report back to CHIRblog readers on health-related news from that gathering.