Chronic Disease Patients Raise Alarm Over Cost-Sharing for Prescriptions

Chronic disease patients in California say they’re being asked to pay more for specialty prescriptions, and that amounts to discrimination. 

Groups representing people with complex conditions like multiple sclerosis, epilepsy and lupus say they’re seeing a shift in drug pricing. They say when it comes to specialty drugs, patients are now having to pay a percentage of the overall cost, instead of a fixed payment. 

Liz Helms of the California Chronic Care Coalition says that often means patients with long-term conditions have to pay more for drugs.    

“They’re being treated differently than everybody else in the system," says Helms. "And we say that insurance needs to be spread out, the risk spread out.” 

The California Association of Health Plans says insurers are trying to keep plans affordable.  Charles Bacchi of the Association says there’s been a boom of specialty drugs in the market.

“Drug formularies are created to help control rising drug costs, which in America today, are a real challenge. Especially specialty drugs," says Bachi.

Bacchi says the Affordable Care Act protects most consumers from high health costs by capping the amount paid out of pocket to about $6,300 a year.