How to Write Pharma a Blank Check by Policy

Insulin Pens

When you want to write major pharmaceutical manufacturers a blank check, you write bad policies. That is happening in Michigan and many other states.

The Michigan House of Representatives crafted a bill HB4701 which would cap insulin co-pays at $100. In theory this sounds like a win for consumers right?

This actually creates numerous problems such as:

  • Most patient co-pays over $50 are abandoned at the pharmacy.
  • Only 25% of Michiganders would get co-pay relief because under federal law this bill cannot be applied to:
    • Self-funded employer-based insurance plans (most companies with 300 or more employees fall into this group)
    • Insurance funds that are managed by a labor union
    • Medicare or any insurance endorsed by Medicare.
    • High Deductible Health Plans
  • Pharmaceutical manufacturers will have no incentive to manage their prices.

The last problem might not sound like a big deal. However, as prices go up so does the cost of insurance. Which means if big pharma is left unchecked, everyone pays. That is how insurance works. By creating a pool of money with premiums, you generate cash to pay claims. If the cost of claims goes up, the pool of money needs to be increased using increased premiums.

The solution is to urge lawmakers to create a law that requires drug manufacturers to pay the entire out-of-pocket costs for any drug with a National Average Drug Acquisition Cost of $5 per dosage unit with a dosage unit defined as a “milliliter, tablet, capsule, or pre-filled single dose package.” The legal mechanisms can be the use of pass-through rebates in Medicare plans to copay cards which are already offered by manufacturers.

Get involved and make sure your lawmakers know that pharmaceutical manufacturers do not have a blank check to pillage our health care system.

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