Personality: Dana A. Kuhn
Spotlight on founder of nonprofit that helps ill afford medications
3/5/2015, 5:55 a.m.
Most frequently requested Patient Services Inc. assistance: Approximately 80 percent of PSI’s assistance is for copayment affordability. This seems to be the greatest challenge for patients with rare and chronic conditions.
Patient Services’ No. 1 project today: Utilizing the latest technology to ensure that our patients can easily apply and receive assistance. To that end, PSI has been undertaking a redesign of its IT platform, which will provide our patients with enhanced customer service and reporting, paving the way for PSI to be the premier nonprofit organization of its kind moving into the next 10 years.
Strategy for achieving it: 1. Listening to our patient’s needs! 2. Leveraging the latest technology available. 3. Utilizing the talented and caring staff at PSI.
Fair Copay VA Campaign is: This year, PSI led the Virginia Alliance for Medical Affordability and Access in a legislative campaign called Fair Copay VA. The campaign addresses the need for fairness in the affordability of copayments for prescription drugs. Health insurers increasingly are moving medications to “specialty tiers,” where there is no limit on the out-of-pocket costs that patients must pay. Al- though any Virginian can be subjected to unreasonably high out-of-pocket costs, those most likely to be affected are living with life-threatening or chronic conditions, such as cancer, hemophilia, hepatitis C, multiple sclerosis and HIV/AIDS. This year, Fair Copay VA advocated for legislation, House Bill 1948, to limit the amount that insured Virginians pay out-of-pocket for these vital medications.
Why House Bill 1948 is needed: Rather than paying a manageable and fixed copayment for their medications, Virginians whose treatments are placed on specialty tiers often are forced to pay coinsurance — or a percentage of the total cost of the drugs. This can mean hundreds or even thousands of dollars per month in additional out-of-pocket costs for just a single medication. Virginians pay their premiums expecting their medical conditions to be covered, only to learn they are not. Making sick people bear a far larger portion of their treatment costs undermines the very concept of insurance. High out-of-pocket costs not only have harmful financial consequences for patients, they also damage patient health and drive up overall costs to our health care system, increasing costs by $100 billion each year. That’s because patients who can’t afford their medications often cut back or discontinue treatment altogether, making them more vulnerable to hospitalization and exacerbated conditions. By hiking out-of- pocket costs, health insurers are destroying a critical safety net for Virginians, often when they need it the most.
Why there was opposition to House Bill 1948: The legislation faced opposition from insurers that are utilizing specialty tiers to pass costs on to patients. The reality is that insurers need to manage costs without penalizing patients. Specialty tiers have increased dramatically over the last decade, despite the fact that prescription drug prices make up only a small portion of health care spending, and drug costs have remained relatively stable during the last 10 years. There are other more effective and equitable ways to manage costs.