Joco Today

U.S. Senators Roger Marshall and Tim Kaine are leading a bipartisan effort to lower prescription drug costs by urging government agencies to enforce a rule that limits the use of harmful "copay accumulators." These accumulators prevent copay assistance from counting towards a patient's deductible or out-of-pocket maximum, making it harder for patients to afford their medications. The senators, members of the Senate Health, Education, Labor, and Pensions (HELP) Committee, wrote a letter to the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury, urging them to lower out-of-pocket costs for prescription drugs.

The senators also called for the adoption of policies from the 2020 Notice of Benefit and Payment Parameters (NBPP) that would strike a balance between controlling costs and putting the patient first. They are pushing for the passage of their Help Ensure Lower Patient (HELP) Copays Act, which would permanently prohibit the use of copay accumulators and require health plans and Pharmacy Benefit Managers (PBMs) to count the value of copay assistance towards a patient's deductible or out-of-pocket maximum.

The senators' efforts have garnered support from various organizations representing patients with chronic and rare diseases. Anna Hyde, Vice President of Advocacy and Access for the Arthritis Foundation, highlighted the importance of copay assistance for low-income patients who rely on it to afford their medications. Bari Talente, EVP, Advocacy & Healthcare Access, National MS Society, expressed disappointment with the Biden Administration's decision to appeal the court's ruling on copay accumulators, stating that it would negatively impact access to care for those living with multiple sclerosis. Peter Saltonstall, President and CEO of the National Organization for Rare Disorders (NORD), emphasized the detrimental effect of copay accumulator programs on rare disease patients and expressed gratitude for the bipartisan support for the HELP Copays Act.

Leah M. Howard, J.D., President and CEO of the National Psoriasis Foundation, expressed disappointment in the Administration's move to appeal the court's decision and urged the renewal of policies ensuring copay assistance is counted towards deductibles and out-of-pocket maximums. The AIDS Institute highlighted the need for HHS to make necessary and lifesaving treatments more accessible and affordable for vulnerable Americans with rare and serious chronic illnesses. The Cancer Support Community also voiced its opposition to copay accumulator adjustment programs (AAPs) and supported the adoption of the 2020 NBPP policy to protect affordability and access to care for under-resourced patients.

The senators' letter was also signed by a bipartisan group of senators, including Joni Ernst, Ed Markey, Lisa Murkowski, Elizabeth Warren, Ted Budd, Kirsten Gillibrand, Shelley Moore Capito, Cory Booker, Thom Tillis, Chris Coons, Mike Rounds, Chris Van Hollen, John Boozman, Jeanne Shaheen, Susan Collins, Mazie Hirono, and Kyrsten Sinema.

In their letter to the secretaries of HHS, DOL, and the Treasury, the senators expressed support for the recent decision by the U.S. District Court for the District of Columbia that vacated the provision in the 2021 NBPP Final Rule allowing the use of copay accumulator adjustment programs. They urged the agencies to adopt policies from the 2020 NBPP that would prioritize patients while still allowing plans to control costs. The senators also emphasized the importance of patient assistance programs (PAPs) in helping low-income and vulnerable patients access life-saving medicine and called for federal legislative action to restore this vital patient protection.

The senators' efforts aim to alleviate the financial burden faced by patients and ensure that they have access to affordable prescription drugs. By urging government agencies to enforce rules that limit the use of copay accumulators and advocating for the passage of legislation, Marshall and Kaine are working towards lowering prescription drug costs and improving access to essential medications for all Americans.

To find out more, go to this link: https://www.marshall.senate.gov/newsroom/press-releases/marshall-and-kaine-lead-colleagues-in-bipartisan-push-to-lower-prescription-drug-costs/