Here’s what you need to know.
1. To deal with increased costs, many states are making changes to their health plans. Several states have policies to prevent exorbitant spending on prescriptions. Many require preferred drug lists, prior authorizations and comparative effectiveness reviews.
2. But if prices continue to rise states could limit medications or cut reimbursements to health plans.
3. Executive Director of the National Academy for State Health Policy Trish Riley said the states are close to hitting their breaking points. “It’s not just the increase, it’s the unpredictability of it,” she said in the report.
4. The EpiPen and drugs for hepatitis C are two such examples where states have to make hard decisions.
For hepatitis C several states were requiring prior authorization to prescribe appropriate drugs. The EpiPen was not that easy however. As the pen is a necessity for a person in the midst of an allergy attack, states had to pay whatever price was quoted to them.
5. The Hill argues that states adopt a pull-and-push policy, where certain drugs are allocated more money while cuts are made in other places.
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