Indiana Legislature Passes Bill Protecting Patients from Paying More Than Their Insurers

PhRMA Public Affairs recently carried the good news that Governor Holcomb of Indiana has joined the governors of Arkansas and West Virginia by signing a law aptly named ‘Share the Savings’ directed to insurers and middlemen called pharmacy benefit managers (PBM).

The goal is that savings, such as discounts, rebates, and various concessions towards pricing given to insurers and PBM, will now be shared with patients at the pharmacy and put back in their pockets.

Substantial Savings

The very substantial savings are the result of negotiations between providers, pharmaceutical organizations, and PBMs. In 2021 the discounts and rebates totaled $236 billion.

Residents in Indiana have been struggling to pay their medical bills. In many instances, the discounts and rebates have not been shared with patients. This would mean that some of the patients have been paying more for medicine than the PBMs and insurers. The new law, however, means that they will now be required to share those discounts, rebates, and other manufacturer price concessions with patients at the pharmacy counter.

The law now requires that eighty-five percent of the rebates received by health insurers in the individual market be used to lower the cost of drugs purchased in pharmacies.

As for the commercial market, insurers must now pass along one hundred percent of rebates they receive to employers who in turn will decide how they will distribute the out-of-pocket savings to employees.

A potential benefit would be the improved outcome for people who will be able to afford their medication.

By Popular Demand

As evidence that many people have difficulty managing the cost of their medication, the Morning Consult, sponsored by PhRMA, conducted a fifty-state survey. The majority of respondents in each state said that out-of-pocket healthcare costs should head the list of government priorities.

Respondents in Indiana were in support of laws that would ensure patients would not pay more for prescriptions than their PBM or insurance company.

They were also in favor of health insurers and PBMs being held responsible for any role they may have played in preventing patients from receiving life-saving medication.

 

Rose Duesterwald

Rose Duesterwald

Rose became acquainted with Patient Worthy after her husband was diagnosed with Acute Myeloid Leukemia (AML) six years ago. During this period of partial remission, Rose researched investigational drugs to be prepared in the event of a relapse. Her husband died February 12, 2021 with a rare and unexplained occurrence of liver cancer possibly unrelated to AML.

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