One of the most active areas of activity will likely be copay accumulator ban legislation. The UnitedHealthcare policy proposal that would have required physicians to report when patients use copay assistance for specialty drugs raised awareness of the importance of this issue. Although the policy has been placed on hold, it still looms large as a warning of things to come. Current estimates suggest 20 or more accumulator bills may be introduced in the coming session.
Drug prices will continue to be an issue on which states are increasingly active. Recently, pharmacy benefit manager (PBM) legislation has been at the center of state cost control efforts. However, in the past year-and-a-half, a marked decline has been seen in proposals that would aggressively regulate PBMs. Instead, we see more ad hoc measures that are chipping away at PBMs from the edges. The outcome of Rutledge v. PCMA in the U.S. Supreme Court could reignite aggressive PBM regulation at the state level. The case was heard by the court in October, but will not be decided until next year.
In addition to PBM regulations, states have increasingly sought to increase transparency throughout the drug supply chain. Proposals to monitor and cap price increases by pharmaceutical companies, as well as premium and out-of-pocket cost increases imposed on patients by payers have been set forth. Whether any of these proposals will be successful in the current environment remains unclear, but these proposals likely represent the coming wave of transparency reform.
Final Thoughts
Across the political landscape, 2021 promises to be another interesting year. To maximize our impact, we need your help. Your advocacy is essential to our success. Now more than ever, we need both the time and financial commitment from ACR/ARP members to bring about positive change in health policy. Continue to complete VoterVoice campaigns, email and call your legislators, and give to RheumPAC. If we can help you with any advocacy-related issues, contact our advocacy team at [email protected].
