- The pharmaceutical industry has faced a great deal of criticism as patients have found it challenging to get the medications they want. The main challenge is lack of sufficient reimbursement.
- To counter this criticism, the Pharmaceutical Researchers and Manufacturers of America (PhRMA) is launching a site—AccessBetterCoverage.org—to explain how coverage decisions are made.
- While the site does detail important facts such as the difference between co-pays and co-insurance, as well as how formularies and tiers work, its real intended message to consumers is that health insurers are shifting the costs of drugs to the consumer.
People are angry about the high cost of drugs, and for the most part, they have been directing that anger towards pharmaceutical companies. Patients face record co-pays and in some cases must pay the full cost of drugs despite having insurance. PhRMA also points out that patients enrolled through Obamacare plans tend to have even more difficulty accessing drugs.
In a press release from PhRMA, President and CEO John J. Castellani said, “We know health coverage can be confusing and overwhelming—particularly for those purchasing it for the first time—so we wanted to create a simple, straightforward resource to help demystify the process and equip patients to make coverage decisions that are right for them. Our primary goal is to ensure patients have access to the health treatments and services they need.”
On the flip side, however, members of the insurance industry accuse pharmaceutical companies of overpricing their products and expecting insurance companies to cover those costs. While the new site will help to demystify terminology and some of the technical underpinnings of the insurance industry, the problem will not be solved in this way. This is a classic case of reciprocal blame-shifting—finding a real solution to the issue is going to take a lot more than that.