Taking a Stand: Safety Concerns with Drug Importation

The Issue To reduce patients’ spending on prescription drugs, both Congress and a number of states are considering legislation that would allow Americans to purchase supposedly much cheaper medicines from Canada and elsewhere, which could put Americans’ health and...

Telling the Truth About Copay Accumulators

In 2018, many insurers and pharmacy benefit managers (PBMs) introduced copay accumulator programs to the American public, using such pleasant sounding names as “Out of Pocket Protection” and “Coupon Adjustment: Benefit Plan Protection” to lull consumers into believing...

Fighting Nonmedical Switching

Under a practice known as nonmedical switching, pharmacy benefit managers (PBMs) can force patients to change from a medication they rely on to a less costly and possibly less effective drug for financial reasons, not medical ones. PBMs accomplish this by dropping the...

Rein in the Use of Step Therapy

Decisions about a course of therapy that were once exclusively made by the doctor and patient are now being overturned by a common insurance practice called step therapy,  or what is sometimes called “fail first.” Requiring patients to try one or more less expensive...
It’s Time to Reform Prior Authorization Requirements

It’s Time to Reform Prior Authorization Requirements

Although it is now possible to detect diseases earlier and treat them more effectively, the reality is many Americans are not getting timely access to the new technologies and improved therapies responsible for these gains. One reason has to do with prior...