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Tuesday, July 07, 2015

Capping Drug Prices

As more expensive specialty drugs come on the market to treat some of the most serious chronic diseases, more states are stepping in to cushion the financial pain for patients who need medicine that can cost up to hundreds of thousands of dollars a year.

At least seven states — Delaware, Louisiana, Maine, Maryland, Montana, New York and Vermont — limit the out-of-pocket payments of patients in private health plans. Montana, for instance, caps the amount that patients pay at $250 per prescription per month. Delaware, Maryland and Louisiana set the monthly limit at $150 and Vermont at $100. Maine sets an annual limit of $3,500 per drug.

New York prevents insurers from listing specialty drugs in a separate category that allows for charging higher payments out of pocket.

In an effort to hold down prices, legislators in other states, including California, Massachusetts and North Carolina, have proposed requiring companies to make broad financial disclosures justifying their high drug prices. So far, no such law has passed.



Anonymous said...

Just legalize ALL drugs , make them "over the counter" prices will tumble.

Anonymous said...

That confuses me. When I tried to get Crestor is was a couple of hundred dollars. How is that capped?

Anonymous said...

6:14 that is not true, when they OTC'ed allergy medication (clarion) is was over $5 a pill. Prescription I paid $20 for 30 pills.

Anonymous said...

The states can put all the limits they want on these drug prices, but if the insurance company doesn't want to cover the portion that the patient doesn't pay, then they will just not authorize it. Doctor's offices spend a huge amount of time trying to get a prescribed drug authorized because the insurance company won't cover unless they have tried older, less expensive drugs first and documented that they didn't work.

Anonymous said...

If they would stop all the advertising of prescription drugs, the prices would plummet!

Anonymous said...

6:20 I think you mean clariton. It wasn't only clariton. Zantac and Pepsid AC had prescription strength tablets that cost me only $5 for a 30 day supply. OTC jumped them up to that same level. Just another example of the greed that pervails in today's world.

Anonymous said...

Cap the prices, take away the incentive for research and development of new treatments.