- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
The Battle Over Increasing Drug Costs
The biggest battle in healthcare these days-besides the ongoing fight over Obamacare-is over the price of expensive life-saving medications.
The biggest battle in healthcare these days—besides the ongoing fight over Obamacare—is over the price of expensive life-saving medications.
The fight centers on how drug benefits are designed in health plans, particularly the use of benefit tiers. Health plans usually put lower-cost and preferred drugs at lower tiers that come with smaller out-of-pocket costs. But in the last few years, tiers have become more complex.
The tiers have grown from 2 to 3, 4 and 5. Plans now often distinguish between preferred generics and non-preferred generics, as well as preferred and non-preferred brand name drugs. Specialty medications, which according to one estimate cost 50 times more than a traditional brand-name drug, are found in the highest tiers. Patients usually pay a percentage of the cost of these expensive drugs, or co-insurance, in contrast to the set co-pays charged for medicines in lower tiers.
Read more at The Washington Post's Wonkblog: http://wapo.st/1x3T0pD
Neurologists Share Tips for Securing Patient Access to Gene Therapies
March 19th 2025Tenacious efforts at every level, from the individual clinician to the hospital to the state to Congress, will be needed to make sure patients can access life-saving gene therapies for neuromuscular diseases.
Read More
Bustling Gene Therapy Pipeline for Neuromuscular Diseases Brings Thorny Questions to the Clinic
March 18th 2025The rapid development of gene therapy options for treating neuromuscular diseases has created new therapeutic options but also logistical hurdles and a need for complex discussions between clinicians and families.
Read More
