One in two Pennsylvania adults experienced an affordability burden due to the high costs of healthcare in the past year.
State Rep. Malcolm Kenyatta, D-Philadelphia, speaks at a gathering on Jan. 6, 2023, at the Pennsylvania Capitol in remembrance of the Jan. 6, 2021 attacks on the U.S. Capitol. January 6, 2023. Dan Gleiter | [email protected] 2017, my mother tragically passed away from a stroke brought about by diabetes.
She was my rock and my best friend. And it was tragic to watch her chronic disease and the sky-high cost of her prescription drugs cost her her life. I know so many Pennsylvanians reading this share a similar story of a loved one who left us too soon due to being unable to afford care or medication they so desperately needed. It’s time for us to change the narrative, and we can start by banning copay accumulators.
Copay accumulators may not be a familiar concept to most, but they’ve caused a huge financial burden for Pennsylvanians struggling with chronic illnesses. Friends, neighbors and members of the community that I’ve heard from who have cancer, heart disease, cystic fibrosis, and sickle cell have all found themselves struggling to afford their medication because the financial assistance they had relied on to bring their prescription costs down now, instead, just assists the insurer’s bottom line.
Here’s how it started: a few years ago, insurance companies and Pharmacy Benefit Managers began to exploit an omission in our health care laws that allowed them to categorize specialty medications as “non-essential,” despite the fact that for almost 80% of the drugs in this category, there are no generic alternatives available. Insurers don’t need to count funds given by third parties for “non-essential” drugs toward their customers’ copay or out of pocket maximum.
Patients with chronic illnesses such as cystic fibrosis or lupus, who were enjoying the promise of a longer, more manageable life thanks to modern medicine, are facing jeopardy again as family members have to watch them struggle with choosing between protecting their next meal or their health., one in two Pennsylvania adults experienced an affordability burden due to the high costs of healthcare in the past year.
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