High out-of-pocket costs also impact patient health: consumers with higher drug cost-sharing are more likely to fail to start, to abandon, or to delay treatment. And many consumers take matters into their own hands by reducing the dosage and regularity of their drug intake, asking providers to prescribe less-expensive medications, or using alternative therapies to offset high out-of-pocket costs. Unsurprisingly, this reduced drug adherence can result in potentially worse health outcomes and higher health care costs.
Although much attention is focused on federal policy change to address high drug prices, many overlook the role that state policymakers play in protecting consumers from the effects of drug price gouging.
To highlight this role, a diverse group of patient and consumer advocates appointed to serve as consumer representatives to the National Association of Insurance Commissioners (NAIC) recently released a report on options for state regulators and policymakers to promote access, affordability, nondiscrimination, transparency, and meaningful oversight of prescription drug coverage.
The report reflects the latest research and data on specific topics, such as drug cost-sharing, adverse tiering, health disparities, and value-based pricing, among many others. In particular, the report includes a set of recommendations and features examples of promising practices in a wide variety of states such as California, Massachusetts, Montana, Nevada, New York, Texas, and Vermont.
The findings suggest that state policymakers have significant flexibility and a variety of options to promote consumer access to prescription drugs in a way that meets the needs of their state. The report also shows that state legislators and insurance regulators can, do, and should continue to adopt policies that help provide consumers with the affordable prescription drugs they need.
The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.