Margaret Barton-Burke on Exchanges

The dramatic cost shifting to vulnerable populations that is taking place within the Health Insurance Exchanges is troubling. The Oncology Nursing Society (ONS) believes that access to cancer care is the right of all people. While the Affordable Care Act (ACA) expanded access to insurance coverage, unaffordable co-insurance payments continue to threaten access to cancer care. The vast majority of plans in the Health Insurance Exchanges place an unreasonable out-of-pocket cost burden on patients by requiring significant co-insurance for the vital medications used to treat serious health conditions according to new research from Avalere Health. The study demonstrates that in seven of 19 classes of medicines for serious illnesses, such as cancer, more than 20 percent of plans require co-insurance of 40 percent or more for all drugs in that class. In 10 of the 19 selected classes at least 20 percent of plans require co-insurance of 30 percent or greater for drugs in the class. The life-saving classes of oncology drugs affected include metabolic bone disease agents, antineoplastics, and antiemetics. The study finds that more than 60 percent of plans place all covered medications for certain types of cancer treatments in the plan’s highest formulary tier with the highest level of cost sharing. Instead of paying a co-payment, patients are charged co-insurance. As a result, patients receiving medical treatments like chemotherapy can be hit with huge out-of-pocket costs. These formu...
Source: PHRMA - Category: Pharmaceuticals Authors: Source Type: news