Drug-makers volley attack against insurers over O-Care subsidies

The leading pharmaceutical trade group is criticizing insurance carriers on ObamaCare's exchanges for purportedly failing to help consumers afford high-cost medications.

In a blog post Tuesday, the Pharmaceutical Research and Manufacturers of America (PhRMA) pointed to new research showing that insurers tended to apply federal cost-sharing subsidies to deductibles and out-of-pocket caps rather than to specific treatments and services, including specialty drugs.

ADVERTISEMENT
The group also blamed the Obama administration for failing to impose constraints on how insurers determine what part of their coverage merits an extra discount for low-income individuals.

Failing to apply cost-sharing reductions to high-cost medications can "ultimately limit patient access to needed treatment," PhRMA spokeswoman Allyson Funk wrote. "As the healthcare system continues to look for ways to contain costs, barriers to medicines must be removed."

The blog post is the latest development in an increasingly hostile public feud between insurers and pharmaceutical companies over the rising cost of specialty drugs.

An analysis by consulting firm Avalere Health, released Monday, found that consumers who are eligible for cost-sharing subsidies under ObamaCare are still likely to pay high out-of-pocket costs on medications.

The research was funded by PhRMA, though Avalere said it maintained control over the findings.  

Brendan Buck, a spokesman for America's Health Insurance Plans, told the Hill that "the skyrocketing prices drug-makers are charging for their treatments" is the reason individuals are suffering.

"These companies know that private insurance and government programs are going to pick [up] the vast majority of the cost, so they are pricing their drugs as though the sky's the limit, increasing consumer costs in the process," Buck said.

More in Overnight Healthcare

OVERNIGHT HEALTHCARE: Insurance giant to brief Congress on cyber hack

Read more »