Impacts to Out-of-Pocket Prescription Drug Costs
TUCSON, AZ (February 16, 2017) – A December 2016 analysis by the Kaiser Family Foundation illustrates how prescription medications will be a large portion of overall healthcare spending, and how branded drug prices have nearly doubled. The analysis also explains that 1-in-4 people have difficulty affording their medicines, and that most Americans favor actions to keep drug prices down, (Kaiser Family Foundation, 2016).
Unfortunately, a repeal and replacement of the Affordable Care Act (ACA-Obamacare) could end up increasing drug costs to insured consumers and leaving millions of Americans uninsured. A report written by the Congressional Budget Office states, “repealing major provisions of the Affordable Care Act, while leaving other parts in place, would cost 18 million people their insurance in the first year and an estimated 32 million people in 2026,” (Congressional Budget Office, 2017). The study also projects that insurance premiums would increase by 25 percent in the first year, then double by 2026.
Regardless of the changes made to the ACA, the end-result will have detrimental impacts on the American healthcare coverage. Even a partial repeal could include heavy changes that will increase costs to consumers. Insurance plans may no longer be required to cover essential health benefits (EHB) in accordance with benchmark plans. Examples of the potential impacts include:
- Removal of no-cost preventative coverage
- Restrictions on maternity and family planning coverage
- Exclusions of prescription drugs for many diseases and conditions
- Elimination of prescription drug coverage altogether
The message is clear, even for those retaining their insurance – Americans will be shouldering more out-of-pocket costs for prescription drugs.
“Any reduction in benefits to emerge from a replacement of the law, especially to the essential minimum benefit set, would likely drive patients without adequate drug coverage to seek solutions to combat high priced prescription drugs,” stated Rory Rickert, Principal with QuarterLine Consulting, a national healthcare consulting and services firm. “I expect that changes to the Affordable Care Act would, if anything, result in increased demand for pharmacy discount programs like those offered by ScriptSave,” added Rickert.
To help populations gain some relief from the upcoming change in their healthcare, ScriptSave® WellRx provides an alternative to paying full price for prescription medications. WellRx enables individuals to compare prices at local pharmacies, look up drug information, and setup reminders. Through a partnership with SinfoníaRx, members can even consult with a pharmacist to ask detailed questions about the medications they are taking.
Not only does WellRx give discounts on prescriptions not covered by insurance, it may even provide discounted prices lower than insurance copays. The program is available as a stand-alone for consumers (wellrx.com), white-labeled option for organizations, or an integrated solution for health care organizations (WellRx Connect).
“The future of healthcare is uncertain at this time, but no matter the outcome, no one should ever overpay for prescription medications. ScriptSave can help healthcare consumers with high deductible health plans, limited insurance, or no health insurance at all,” said Marcus Sredzinski, COO and Executive Vice President, ScriptSave. “Our products help consumers save money on prescriptions, understand their medications and, most importantly, remain adherent. We can help organizations and individuals impacted by the repeal and replacement of ACA, or any changes to their insurance status,” added Sredzinski.
This may be especially poignant in light of recent data published by PatientsLikeMe. From a poll of over 2,000 patients, their survey showed:
- 65.5% stated that lower costs for prescription medications was a top priority
- A further 30.8% rated lower Rx costs as being important
- Fewer than 4% had little-or-no concern about prescription prices
Furthermore, it’s not just patients with existing health conditions that rank lower prescription costs as a priority – the general public seems to agree. Data from a December 2016 Kaiser Health Tracking Poll found that lowering the cost of prescription drugs was listed as being important or a priority for 89% of the general population.
When opinions like these are voiced, ScriptSave is ready to help by doing what they do best, lower the out-of-pocket costs of prescription medications for consumers.
ScriptSave’s long-standing mission has been to close the gaps in prescription coverage, and has a 20-year history of working with health plans and pharmacies to provide consumers with discounts on prescribed medications. ScriptSave’s WellRx solutions are not only designed to assist consumers directly but can be utilized by employers, employer groups, health plans, PBMs, and other organizations to assist their populations with prescription adherence, savings, and information. The WellRx savings network includes about 62,000 independent and chain pharmacies. In 2016 alone, ScriptSave earned members more than $1.3 Billion in savings.
The Henry J. Kaiser Family Foundation. Analysis of National health expenditure Historical and Projected data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group (Assessed on December 16, 2016). https://kff.org/slideshow/what-are-the-recent-and-forecasted-trends-in-prescription-drug-spending/
Congressional Budget Office (January 2017). How Repealing Portions of the Affordable Care Act Would Affect Health Insurance Coverage and Premiums. https://www.cbo.gov/sites/default/files/115th-congress-2017-2018/reports/52371-coverageandpremiums.pdf
PatientsLikeMe (February 2017). Largest Patient Poll on ACA Shows Patients Value Health Care Law More Than the General Population, Are Less Inclined to Want a Repeal. https://news.patientslikeme.com/press-release/largest-patient-poll-aca-shows-patients-value-health-care-law-more-general-population-
The Henry J. Kaiser Family Foundation (January 6, 2017). Kaiser Health Tracking Poll: Health Care Priorities for 2017. https://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-health-care-priorities-for-2017/
For more than two decades, ScriptSave has been closing the gaps in healthcare and prescription coverage with innovative savings programs for the uninsured, under-insured, and insured. Headquartered in Tucson, ScriptSave solutions, analytics, and unique expertise save consumers money and increase medication adherence, while attracting and retaining loyal, profitable customers, members, and patients for our clients. ScriptSave is a member of the MedImpact, Inc. family of companies. For more information, go to www.scriptsave.com. Follow us: @SSWellRx (Twitter), ScriptSave WellRx (Facebook).
QuarterLine is a health-focused services company specializing in providing Information Technology, Clinical, and Professional services to federal and private sector customers. QuarterLine supports a diverse client base in all areas of health, including navigating the complex regulatory and business environments, emerging health programs, and technology. QuarterLine’s mission is to provide the right level of support at the right time to our customers to ensure that the outcome of the initiative or the resulting technology delivers the needed results to improve healthcare delivery and increase efficiency. QuarterLine is headquartered in Herndon, Virginia. www.quarterline.com
SinfoníaRx, a wholly owned subsidiary or Sinfonía Healthcare Corp, is an innovative health care company whose mission is to provide the highest quality healthcare solutions for health plans, patients, and caregivers. We improve the health and wellness of patients with complex and chronic illnesses through the use of innovative healthcare technology and the most experienced medication therapy management providers in the nation. www.sinfoniarx.com
Shawn Ohri, Vice President of Business Development
Rory L. Rickert, Principal
Kevin Boesen, 520-499-3376