While health insurance is meant to reduce patients’ financial risks if they require expensive medical services, it often fails to do so. This is particularly problematic for patients who need expensive prescription medications.
Now a new type of program is making the problem worse.
Third-party vendors are promoting what are known as alternative funding programs — and applying them to high-cost specialty medications. These programs allow employer-sponsored health plans to exclude certain specialty medications from health plan coverage.
These programs hurt patients, impact the broader health care system and worsen the already dysfunctional drug pricing market.