CMS invites patients, caregivers and members of the public to share written feedback about the drugs selected for negotiation. This input can include information about how a medication is used in real life, what treatment options exist or do not exist, where needs remain unmet

When the government negotiates drug prices, those decisions affect whether patients can access the medications keeping them alive, stable and functional. That's why the Medicare Drug Price Negotiation Program includes formal opportunities for you to share your real-world

You don’t have to be a policy expert to participate. CMS is looking for clear, real-world insight into how medications are actually used and how access affects health and daily life. The value comes from the information that explains how a treatment functions outside of clinical

You are the expert of your experience, and with that experience, you possess a critical influence that could play a role in how others in your community have access to medications. Under the Inflation Reduction Act, Medicare is negotiating prices for top-selling drugs to lower

The Partnership to Fight Chronic Disease released a statement last year after Avalere conducted a survey of regional and national plans on Prescription Drug Affordability Boards and their Upper Payment Limits. The survey captured how plans expect to adjust coverage and

When a Prescription Drug Affordability Board sets limits, it doesn't guarantee that prices will be lower for patients. Your insurance company, and the PBM, respond by tightening formularies, increasing prior authorization and pushing step therapy. That leaves taxpayers paying for

What if we told you that this isn’t an exaggeration? On paper, Prescription Drug Affordability Boards look like they’re saving you money at the pharmacy, but in practice, it never actually happens.

When drug pricing policy focuses on insurers, patients are often left to absorb the consequences.

PDABs exercise their authority through pricing limits that ripple through insurance design, pharmacy access and coverage decisions. And when PDABs set pricing limits, insurers respond by tightening coverage rules to manage financial risk, and that often shows up as more prior

When a PDAB decides a drug costs too much, it can change how insurance companies handle that medication. To avoid losing money, insurers may add more rules before they agree to pay for it, like making patients try cheaper drugs first or get extra approval from the insurance

The 340B program now sits at the center of the hospital marketplace, influencing pricing and care far beyond the safety-net institutions it was meant to support. As its footprint has grown, questions about accountability and patient benefit have become harder to ignore,

Jennifer Garzia attempted to dispute a charge with her hospital after having her third C-section, and it revealed how little leverage patients have once billing departments refuse to reconsider a claim, even when insurers and physicians agree an error exists. That experience also

A patient will hear “federal drug discount program” and reasonably assume that lower bills or at least a clear explanation of how the savings work in their favor. Not so much. What actually happens is hospitals can buy medications at steep discounts through 340B, yet patients

For years, hospitals have pointed to the 340B Drug Pricing Program as evidence of their commitment to caring for patients who cannot afford treatment. The idea is that access to discounted drugs allows hospitals to stretch resources and provide more charity care. Participation

Charity care is often cited as the justification for broad hospital participation in 340B, but the math suggests that justification deserves closer scrutiny.

According to new data from the Health Resources and Services Administration, in the 2024 calendar year, 340B covered entities purchase more than $81 billion (that’s with a B) in covered outpatient drugs under the federal discount program. This is a 23% increase from 2023.

At the beginning of November, the U.S. Senate Health, Education, Labor, and Pensions Committee held a public hearing on the 340B Program, and in her op-ed with RealClear Health, Chief Mission Officer Terry Wilcox is asking congress to prioritize a simple solution — adding a

The problem with 340B extends beyond hospitals. In her op-ed on RealClear Health, Patients Rising Chief Mission officer Terry Wilcox highlights how PBMs are also exploring 340B. “Both CVS and Walgreens add "third-party administrative services fees" that generate hundreds of

Terry Wilcox continues to be outspoken against the lack of accountability in the 340B Drug Pricing program, because she believes that patients deserve to see direct benefit from it. In a recent op-ed pulled in RealClear Health, Terry points out the investigations that uncover

Two years after giving birth, Lauren Gonzalves opened a bill saying her insurer wouldn’t cover part of her maternity stay. According to CBS News, the charge was nearly $2,000, down from an original $9,000 in nursery fees. She had already paid her $2,300 out-of-pocket maximum