Patient-Doc Task Force Building Legal Case Against Alternative Funding Programs
From illegal importation under FDCA to possible ERISA, HIPAA and ACA violations – a task force led by CancerCare is pushing regulatory agencies with levers to go after employer plans use of alternative funding programs for specialty drugs, which they say violate multiple federal laws.
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Programs only allowed for brands with generic competition under court ruling, but related programs such as copay maximizers and so-called ‘alternative funding’ programs are not directly impacted by the decision.
Drug Channels’ Adam Fein described the ongoing and escalating battle between manufacturers and payers over the cost of specialty drugs during a recent webinar.
Legislation to delink PBM payments from drug prices advances in House Energy and Commerce health subcommittee, putting a key pharma priority closer to the finish line. Whether patients will see any benefit remains a worry.