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Report: Health Exchange patients may end up spending more on Rx medicines than employer plans

BY Michael Johnsen

WASHINGTON — A new report by Milliman released Thursday found that Silver plans with combined deductibles offered through the Health Insurance Exchanges may require patients to pay more than twice as much out of pocket for prescription medicines overall as they would under a typical employer plan. This is a far larger increase in out-of-pocket costs than was found for other medical care, noted the Pharmaceutical Research and Manufacturers of America, which commissioned the study

With combined deductible plans, patients are responsible for 100% of their non-preventive medical and pharmacy costs before meeting the deductible. The findings reveal that the large combined deductibles for all medical spending that are common in Silver plans in Exchanges may disproportionately impact out-of-pocket costs for patients relying on prescription medicines. The report looks at Silver plans because they were the most popular in the enrollment period that ended March 31. 

“Americans participating in the Exchanges were promised coverage comparable to employer plans, and yet the reality is that many new plans are failing to provide an appropriate level of access to quality, affordable health care,” said John Castellani, president and CEO of PhRMA. “Patients face hurdles in accessing the medicines they need to manage their conditions, which is particularly problematic for Americans trying to control their chronic diseases.”

The Milliman report also noted that Silver plans are nearly four times more likely to have a single combined deductible for medical and pharmacy benefits (46% of the time) compared to typical employer-sponsored plans (12% of the time). This is an important distinction, particularly for patients with chronic illnesses, as it means prescription medicines are not covered until patients meet the deductible. According to Milliman’s analysis, the typical deductible for Silver plans is $2,000, PhRMA reported. Previous research from Avalere Health found that in the lower-cost Bronze plans, deductibles are even higher, averaging more than $4,000.

Further, the report concludes that Silver plans with combined deductibles impose 130% higher cost sharing for prescription medicine than typical employer-sponsored plans, compared to about a 20% increase for other healthcare services for members without subsidies who previously had typical employer coverage.

Studies have found that higher out-of-pocket costs reduce patients’ likelihood of taking prescription medicines to manage chronic conditions. The result is an increase in hospitalizations and higher healthcare costs overall. Conversely, programs that encourage better adherence have the potential to reduce emergency department visits, hospitalizations and other preventable, costly care. In fact, according to a 2012 Health Affairs study, improved medication adherence for patients with diabetes has the potential to save $8.3 billion each year.

“Medicines are one of the most significant contributors to improved quality and length of life for people with serious diseases, such as chronic illnesses, cancer and HIV/AIDS,” Castellani said. “To improve health and, in turn, control healthcare costs, we must continue to work toward a healthcare system that improves access and adherence to medicines.”

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david2775 says:
Jul-30-2014 02:28 pm

New group prescription drug card is saving Americans up to 90% on their prescriptions. Anyone can now enroll in this program for only $7.95 per month and get the same type of savings as someone who has a group rx card in their employee benefit package...

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Bounce adds new fabric care product to the mix

BY Ryan Chavis

CINCINNATI — Bounce, a brand from Procter & Gamble, announced the launch of its first-ever, in-wash fabric care product, Bounce Bursts. The product comes in a bead form that gives consumers control over the amount of scent they would like to add to their wash.

The product’s Outdoor Fresh scent also adds to the experience for the consumer, helping to improvemood and energy throughout the day thanks in part to time-release "freshness capsules," the company said. 

“Bounce understands that there are moments when we’re unable to enjoy the scent of the great outdoors and has designed Bounce Bursts to give fabrics that extra boost of Outdoor Fresh scent throughout the day,” said Vedran Miletic, associate marketing director, Procter & Gamble. “For many, the scent of Bounce has been a recognizable staple in their laundry room for generations, and they’ve enjoyed the Bounce Outdoor Fresh scent from the dryer. Now, we’re giving them more of what they love with an in-wash scent booster that gives your clothes freshens which will stay with them throughout the day.”

Bounce Bursts are now available nationwide for a suggested retail price of $6.99. 

 

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GPhA pushes for greater access to generics at TPP meeting

BY Michael Johnsen

WASHINGTON — The Generic Pharmaceutical Association lobbied for greater access to generics at this week’s meeting of the chief negotiators of the Trans-Pacific Partnership in Ho Chi Minh City, Vietnam, the association announced Wednesday.

"GPhA supports trade agreements that protect timely and cost-effective patient access to beneficial generic drugs and biosimilars, and that also respect the rights of innovators," stated Ralph Neas, GPhA president and CEO. "Importantly, trade agreements should not constrain job growth in the U.S. by blocking or delaying exports of generic drugs to foreign markets. Any final agreement should support the U.S.-based generic industry and open foreign markets for generic products." 

GPhA strongly objects to any provisions that could threaten competition including patent linkage and exclusivity periods for reference products that unnecessarily delay access to lower-cost generic medicines, Neas added.

The Trans-Pacific Partnership is part of a trade agreement that seeks to manage trade, promote growth and regionally integrate the economies of the Asia-Pacific region.

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