Backgrounder: Impact of Restricted Drug Coverage

Restrictions on drug coverage can harm patients and increase health care costs.

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What Are Health Insurance Exchanges?

11.12.14 | By

You’ve probably heard about the Affordable Care Act, health insurance exchanges or even the health insurance marketplace. But what does it all mean? Health insurance exchanges or the marketplace offer an alternative source to purchase health coverage if you don’t buy it on your own, receive it through your employer, or from another public program.

Access to Combination Therapies May Be Limited with Exchange Coverage

10.23.14 | By

Would you rather take three different pills a day, following specific instructions for each, making sure you don’t forget one or just one pill a day that has the same effect?

As drug development advances, so have efforts to simplify medication delivery for patients in the form of combination therapies. These medicines contain two or more pharmaceutical ingredients in one single dose to treat a specific disease. 

Disparities in Health Coverage: Not All Services Are Created Equal

10.22.14 | By

When it comes to health coverage, access to health care services is not always the same. For some, out-of-pocket costs may create barriers to access and hinder adherence to needed services and treatments.

ICYMI – NYT: Unable to Meet the Deductible or the Doctor

10.20.14 | By

In case you missed it, a front-page story in The New York Times this weekend told the story of Patricia Wanderlich and several other patients who, despite purchasing coverage through the health insurance exchange, or marketplace, have found high, and often combined, deductibles are a major hurdle to accessing needed care.

The ABCs of Health Coverage

10.14.14 | By

Insurance jargon can be confusing. Whether you’ve been choosing a health plan annually for years or have coverage for the first time, it can be tricky to figure out exactly what your plan covers and how to prepare for out-of-pocket costs.  

When It Comes to Getting Your Meds, Are You Covered?

10.01.14 | By

Four in five American adults take at least one medication, and more than one in four take five medicines or more. For patients to live longer, healthier lives, being able to access needed treatments is critical. Not to mention, adhering to treatment regimens can help prevent costly and burdensome complications down the road.

Health Coverage 101: Back-to-Basics

09.22.14 | By

Have you ever been confused by insurance jargon? What’s a deductible? A copay? When and how do they apply? You’re not alone. According to a national survey by the Department of Education about health literacy, just more than 1 in 10 American adults understand how to navigate medical care and health insurance.

Coverage without Access: An Analysis of Exchange Plan Benefits for Certain Medicines

A central goal of the Affordable Care Act (ACA) was to expand access to insurance so patients, particularly those with chronic disease, could access the treatments and medicines they need. Recognizing that coverage would have limited value without basic access and affordability, the ACA included a non-discrimination provision, an out-of-pocket spending cap, mandatory coverage of “essential health benefits,” and financial assistance for low-income enrollees.

Affordable Care Act

The biopharmaceutical industry’s top priority is to provide patients with access to high quality medicines. The Patient Protection and Affordable Care Act offers many Americans the opportunity to purchase health coverage through the health insurance exchange. Unfortunately, health insurance exchange coverage may not be all that patients expected. High deductibles, cost-sharing, and restrictive formularies potentially put patient health at risk.


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