Amid efforts to blunt rising medicines costs, a new analysis finds three states succeeded in helping their residents save money by capping out-of-pocket costs on pricey specialty drugs and, at the same time, also managed to avoid increased spending by health plans.
Overall, out-of-pocket spending by patients fell $351 per month in Delaware, Maryland, and Louisiana, each of which passed laws that set $150 caps on what consumers must pay for prescriptions for specialty medicines. These include medications to combat such hard-to-treat maladies as multiple sclerosis, rheumatoid arthritis, and hepatitis C, among others.
This decrease amounted to a 32% drop in outlays among patients who typically spend the most for their medicines, according to the analysis, which was published in the New England Journal of Medicine. Meanwhile, there was no change in health plan spending per person, which was used as a proxy for future changes in premiums.
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Once a patient reaches the cap, which entity absorbes the loss from the reduced co-pay contribution?
I don’ know – but I am guessing the insurers just get less out-of-pocket money from patients.