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Covered California Looking At Ways To Reduce Burden Of High-Cost Drugs

CarbonNYC / Flickr
 

CarbonNYC / Flickr

Covered California is in the process of setting prescription drug benefits for health insurance plans in its 2016 marketplace.

The health plans will base next year's premiums partly on that formula. 

Covered California says consumers and advocates have been asking the exchange to reduce the burden of high-cost specialty drugs.

Dana Howard with Covered California says planners have come up with several ways to design drug coverage keeping access and affordability in mind. 

"Still having the consumer take on a what we believe is a fair share of the cost of the drugs, but in doing so, not make it that they have to reach for instance a $6,000 out of pocket threshold before these drugs become affordable," says Howard.

The exchange voted last week to require health plans to put drug cost information online.

It has defined which kinds of drugs will be in which pricing bracket.

And it will require at least one drug for a particular condition to be in a lower drug-pricing tier.

Covered California has yet to decide whether it will establish a cap on the cost of prescriptions.