MS Focus joined more than 100 organizations to oppose a provision by the Centers for Medicare and Medicaid Services that would increase barriers to access of care and put individuals struggling with chronic and debilitating diseases, such as multiple sclerosis, at risk. They urged the Centers for Medicare and Medicaid Services to omit the provision from the finalized rule.

The provision would require drug manufacturers to include the value of cost-sharing assistance when calculating best price unless they are able to prove that individuals using patient assistance programs, such as copay assistance, are receiving 100 percent of intended benefits. This, the groups argue, would be extremely difficult to prove for manufacturers because of a lack of transparency and the actions of insurers and middlemen.

The groups are concerned the burden of proof will undermine manufacturers’ ability to continue offering patient assistance programs to individuals in the larger commercial market. This is extremely troubling from their perspective, as many patients rely on these programs in order to afford vital drugs and treatments. 

To find out more, visit www.federalregister.gov/documents/2020/06/19/2020-12970/medicaid-program-establishing-minimum-standards-in-medicaid-state-drug-utilization-review-dur-and