Before closing the door on 2019, IfPA looks back at the trends that impacted patient access this year.
1. Patient-centered care took center stage.
The slow creep of one-size-fits-all policies spurred advocates to embrace patient-centered care with renewed gusto. For the Partnership to Advance Cardiovascular Health, that meant endorsing a patient-centered approach to treating cardiovascular comorbidities. For the National Coalition for Infant Health, it meant rejecting rigid rules about which at-risk infants and children qualify for RSV prophylaxis. And for the Alliance for Patient Access’ Neurological Disease Working Group, it meant pushing for flexibility in Medicare requirements that long-term care facilities gradually reduce the dose of certain medications.
2. Research exposed the dark effects of non-medical switching.
A national study from the Alliance for Patient Access painted an alarming picture of how non-medical switching impacts patients. Study participants described struggling to focus at work, losing the ability to care for family members, facing new side effects – and even winding up in the hospital with complications from the insurer-preferred drug.
PODCAST: Sad, Sick & Switched
3. Part D’s out-of-pocket chaos came to a head.
Whether it’s out-of-pocket caps or out-of-pocket “smoothing,” policymakers’ 2019 efforts made one thing clear: Seniors need help managing Part D prescription drug expenses – now. Without better policies in place, seniors face a tough choice: make sacrifices to cover their out-of-pocket costs, or sacrifice their own health.
FAST FACTS: Medicare Part D Prescription Drug Coverage
4. Patients & providers got schooled on ICER.
Who really decides if you – or your patient – can access prescribed medicine? It may very well be a health economist. As the Institute for Clinical and Economic Review declared still more novel medicines not worth their cost, think tanks and advocacy groups educated patients on how ICER’s flawed methodology could make it harder to access treatment.
VIDEO: What’s Wrong with ICER?
FAST FACTS: The Institute for Clinical and Economic Review
5. Heart patients’ struggle busted myths about lower drug prices.
Lower drug prices mean better access for patients – or do they? This year, heart patients learned the hard way that health plan designs plays a bigger role in access and out-of-pocket expenses than they ever imagined.
BLOG: A Tale of Two Drug Codes
6. Migraine clinicians fought back.
New migraine therapies brought elation, then frustration. Health plans blocked access to the long-awaited treatments by restricting prescribers, undermining combination therapy and imposing arduous prior authorizations. But migraine clinicians didn’t take those barriers lying down.
Join us again January 7, 2020 for another year of insights on these and other health policy issues. Happy New Year!