Cutting out-of-pockets costs


COLUMBUS – State Representatives Susan Manchester (R-Waynesfield) and Thomas West (D-Canton) recently unveiled House Bill 469, which will cut out-of-pocket prescription costs for patients.

Patients with chronic, complex conditions such as multiple sclerosis and hemophilia rely on copay assistance programs through drug manufacturers, charities, and churches to help cover the costs of their prescription drugs. Recently, many major health insurance providers have implemented discriminatory policies that no longer allow the payments made through copay assistance programs to count toward a patient’s deductible.

Patients whose health insurance providers use these copay accumulator policies are often blindsided by the discriminatory policies and end up owing thousands of dollars because of unmet deductibles. Additionally, insurers get paid twice for the same medications, meaning they pocket the assistance payment, as well as any copays paid by the patient during the deductible phase.

House Bill 469 protects patients and reduces their out-of-pocket prescription drug costs by prohibiting these discriminatory policies and allowing aid from copay assistance programs to count toward a patient’s deductible.

“These policies discriminate against patients with chronic conditions, as well as those who need innovative prescription drugs for which no generics typically exist,” said Manchester. “House Bill 469 fights to cut out-of-pocket prescription drug costs for our families.”

House Bill 469 will have a lasting effect on patients with rare diseases, saving them thousands of dollars on prescription costs.

“Similar legislation has been passed in West Virginia, Virginia, Illinois and Arizona,” said Manchester. “It’s time we add Ohio to that list.”