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 […]
Tag: co-pay
What is a Clawback & How it’s Affecting Your Prescription Copays
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 […]
Resources for Advocates
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 […]
Finding Assistance with Multiple Sclerosis on NeedyMeds
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 […]
5 Ways to Find Help with Your Diabetes Costs
Treatment and other diabetes-related costs can be expensive. According to the American Diabetes Association the total costs of diagnosed diabetes was $245 billion in 2012, with $176 billion in direct medical costs. “People with diagnosed diabetes incur average medical expenditures of about $13,700 per year, of which about $7,900 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes.” Here are 5 ways available to find help with these costs on the NeedyMeds website. 1. Apply for free or reduced prescription medications through […]