This report provides a series of recommendations to assist regulators, lawmakers, stakeholders, and advocates on ways to promote access, affordability, nondiscrimination, transparency, and meaningful oversight of prescription drug coverage. The report includes examples of existing state and federal approaches to addressing these issues as well as recommendations for consumer-protective policies to be considered by state and federal … More >

This report provides a series of recommendations to assist regulators, lawmakers, stakeholders, and advocates on ways to promote access, affordability, nondiscrimination, transparency, and meaningful oversight of prescription drug coverage. The report includes examples of existing state and federal approaches to addressing these issues as well as recommendations for consumer-protective policies to be considered by state and federal policymakers. The report addresses specific topics such as drug cost-sharing, adverse tiering, mid-year formulary changes, data collection and analysis, and value-based pricing, among many others. Key recommendations include limits on the number of drug tiers that insurers can use; limits on consumer cost-sharing by, for instance, prohibiting coinsurance for prescription drugs; and the adoption of standardized plans with meaningful cost-sharing limits to mitigate the effect of adverse tiering; among many others. The authors of the report serve as appointed consumer representatives to the National Association of Insurance Commissioners and members come from national organizations such as the American Cancer Society Cancer Action Network, the American Heart Association, Consumers Union, and the National Alliance on Mental Illness; state-based advocacy organizations such as the Colorado Consumer Health Initiative, Georgians for a Healthy Future, and the Mississippi Health Advocacy Program; and academic centers such as Washington & Lee School of Law and Georgetown University.

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