This year, Virginia and West Virginia passed legislation that requires all forms of copay assistance to count toward an individual’s deductible. Arizona passed more limited legislation that is a step in the right direction. Arizona requires copay assistance to be counted when no generic equivalent is available or when a patient has undergone step therapy or prior authorization requirement to access the medication. This covers most pulmonary hypertension (PH) therapies.
Advocate voices were particularly important in West Virginia, where the Senate Health Committee chair initially removed the bill from the committee agenda due to pressure from a health insurance company. After hearing from advocates, that same legislator reversed his opinion and became a champion for the legislation, which was ultimately signed into law.
Keep up the momentum! No matter where you live, use PHA’s action center to ask your members of Congress to protect individuals with complex conditions like PH from risky step therapy requirements. Advocates in Illinois can also take action on “copay counts” legislation in their state.
To join PHA’s grassroots advocacy network, email Katie Kroner at Advocacy@PHAssociation.org.