June 10, 2022: Read our op ed in the Gilmer Mirror on How PBMs are hurting Texans with disabilitiesĪpril 8, 2022: Texas Healthcare & Biosciences Institute Pres & CEO Victoria Ford explains what pharmacy benefits managers (PBMs) are and why they matter to Texas consumers. HB 826 (Lambert) / SB 1221 (Zaffirini), would have protected Texas patients from non-medical switching by preventing commercial health plans from switching stable patients from a medication between plan years for no medical benefit and solely due to cost. Fortunately, a bill to continue a single formulary passed. All those drug lists would be very complicated for consumer choice. Medicaid health plans in Texas currently all use the same formulary, but that was scheduled to be broken up into to as many as 19 separate Medicaid formularies. A formulary is a list of prescription medications covered by an insurer, in this case, Medicaid. HB 1283 (Oliverson) will preserve a single Medicaid formulary.People who need infusions generally stay on them for long periods of time, and this bill will remove an administrative burden. HB 755 (Julie Johnson) will prevent commercial insurance from requiring a pre-authorization before every infusion for people with auto-immune disease.After 3 sessions, a ban on copay accumulators finally passed. This makes it harder for consumers to meet their deductible or maximum, resulting in higher out-of-pocket costs. When a consumer receives copay assistance, a copay accumulator prevents those funds from counting toward their annual deductible or other out-of-pocket requirements. HB 999 (Price) will protect consumers from copay accumulators.We are pleased to report several major successes from 2023:
This is the main guiding principle for CTD when working on pharmaceutical policy issues, including access to medication, drug regulation and enforcement, and pharmaceutical research and development. Access to the right medication at the right time is best decided between a consumer and their doctor.
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