In a previous blog post, we explored “clawback” and how it affects the prices of prescriptions. In short, Pharmacy Benefit Managers (PBMs) negotiate copay prices for insurers that are often higher than the cash price paid by uninsured patients all while instituting a “gag rule” for pharmacists to forbid them from revealing the price discrepancy to patients unless asked directly. A number of states have already passed laws banning clawback and gag rules, though a group of bipartisan U.S. senators have introduced a bill the ban gag clauses for PBM-negotiated contracts nationwide.

A recent study by Journal of the American Medical Association (JAMA) found that 23% of all prescriptions filled through insurance ended up costing more than patients who would pay out-of-pocket. Related to this, a national poll from West Health Institute/NORC at

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Americans may be surprised to learn that they could be paying more for their medications with their insurance copay instead of the cash price available to those without insurance. A study published last week found that Pharmacy Benefit Managers (PBMs) undermine claims that negotiated “rebates” with pharmaceutical companies are passed on to consumers. This follows a federal lawsuit filed over the summer after a California woman paid a $164 copay on a medication that can be purchased for $92 from the same pharmacy by anyone not using insurance. This practice is known as “clawback” and is instituted by PBMs who then receive the excess payments from the pharmacy.

Pharmacy Benefit Managers are being found to frequently charge a copay that exceeds a medication’s cash price for generic drugs. Moreover, pharmacists around the country are not allowed to disclose the price discrepancy to patients due to “gag clauses” in their contracts that forbid them

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All About PARE

In last week’s blog post we looked at what resources we have available for Patient Advocates. This week we would like to go a step further and introduce our latest resource for advocates – Patient Assistance Resource Education (PARE). The purpose of PARE is to educate healthcare professionals on how to best utilize NeedyMeds to serve their patients. Advocates and medical office staff complete a web-based and self-paced course that goes in-depth into all of our databases and resources. After completing PARE, advocates will be able to navigate the often confusing and complex world of patient assistance.

One of the primary lessons is on Patient Assistance Programs (PAPs). We currently list PAPs for over 4,381 drugs on NeedyMeds.org. However, many people are unaware of how to apply to a program, and how the programs actually work. Every PAP is different, with different eligibility requirements. Using PARE, advocates and medical professionals will learn how to use NeedyMeds to find and enroll their patients in these programs.

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Here at NeedyMeds our focus has always been to help patients who can’t afford their medications and healthcare costs with information on patient assistance programs, free-clinics, co-pay assistance and more. Beyond working directly with patients in need, we also have a variety of resources available to help patient advocates. The patient advocate community plays an essential role in our mission to help people who cannot afford the costs of healthcare. Many patients do not have access to a computer or the Internet, and rely on patient advocates to help them. In this blog post, we are going to highlight some of our resources for advocates, in hopes that we can help them help those in need.

PAPUS

Every day at NeedyMeds, we are working on our listings of patient assistance programs, contacting the programs directly to update information and get the latest application forms. We have been doing this for years, but there was no way to keep patients and advocates updated on the latest changes and new programs. That changed last year when we debuted a new service – the

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Multiple Sclerosis is a chronic and often disabling disease that attacks the central nervous system. There are approximately 400,000 people living with the disease currently in the United States. According to the National Multiple Sclerosis Society: “Multiple Sclerosis (MS) involves an immune-mediated process in which an abnormal response of the body’s immune system is directed against the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves. The exact antigen — or target that the immune cells are sensitized to attack — remains unknown, which is why MS is considered by many experts to be ‘immune-mediated’ rather than ‘autoimmune.’”

Each person experiences MS differently, with unpredictable symptoms and severity of symptoms. “No two people have exactly the same symptoms, and each person’s symptoms can change or fluctuate over time. One person might experience only one or two of the possible symptoms while another person experiences many more.” Common

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