If you would like to sign up to receive action alerts from the Pennsylvania Bleeding Disorders Foundations you can do so here: https://p2a.co/UDfKJur
You can participate in HFA’s action alert here: bit.ly/HFA_FlyIn2021
Our top priority this year will be keeping the hemophilia line item fully funded and getting the language in the fiscal code to ensure the state funds are distributed to all 7 federally funded HTCs in Pennsylvania.
We are also in support of the following bills addressing issues that impact (or could impact) bleeding disorders patients in Pennsylvania. Please let us know if you have examples or patient stories regarding the following that could make our case for supporting these bills stronger:
Co-Pay Accumulators (HB 1664 and SB 196): A copay accumulator – or accumulator adjustment program – is a strategy used by insurance companies and Pharmacy Benefit Managers (PBMs) that stop manufacturer copay assistance coupons from counting towards two costs: 1) the deductible and 2) the maximum out-of-pocket spending. We currently have one example of this occurring to a patient in Western PA. We are looking for any additional examples of this happening to bleeding disorders patients in Pennsylvania.
Prior Authorization and Step Therapy (HB 225 and SB 225): Prior authorizations (PA) require a physician to request health insurer approval of a prescription drug or other health care services before such care is delivered. Health plans often use PA to restrict access to costly services and therapies—particularly newer treatments. Health plans may also use PA to ensure that a therapy is appropriate and safe for a specific patient. Fail First (also known as step therapy) requires patients to try, and fail, on one or more prescription drugs chosen by their insurance company – not their healthcare professional – before gaining access to the drug that was recommended to treat their health condition. We are looking for any specific examples of a fully insured plan, not providing a timely prior authorization, or continuity of care.
Non-Medical Switching (HB 599 and SB 828): Non-medical switching of medication, whereby a patient’s treatment regimen is changed for reasons other than efficacy, side effects, or adherence, is often related to drug formulary changes aimed at reducing drug costs. We are looking for any examples of this happening to bleeding disorders patients in Pennsylvania.