Rep.
Greg
Murphy
(R-North
Carolina)
introduced
the
Every
Dollar
Counts
Act
on
Tuesday.
It
would
ensure
out-of-pocket
costs
for
covered
prescription
drugs
are
applied
toward
patients’
deductibles
and
maximum
out-of-pocket
limits,
no
matter
where
the
drugs
are
purchased.
More
and
more
patients
are
relying
on
direct-to-consumer
platforms
to
access
prescription
drugs.
These
platforms
include
Eli
Lilly’s
LillyDirect
or
Novo
Nordisk’s
NovoCare,
as
well
as
telehealth
platforms
like
Hims
&
Hers
and
Ro.
Direct-to-consumer
platforms
can
lower
out-of-pocket
drug
costs
by
cutting
out
prescription
drug
middlemen,
according
to
Murphy’s
announcement.
However,
many
health
plans
do
not
apply
out-of-pocket
spending
toward
patients’
deductibles
or
out-of-pocket
limits
unless
the
drug
is
obtained
through
designated
plan
channels.
This
leads
to
patients
often
having
to
“pay
twice”
and
facing
more
“financial
burden,
fragmented
access,
delayed
care,
and
market
distortion,”
the
announcement
stated.
That
is
what
the
bill
seeks
to
change.
“Direct-to-patient
platforms
have
the
potential
to
radically
transform
the
drug
marketplace,
applying
much-needed
downward
pressure
on
the
extraordinary
cost
of
lifesaving
medicines.
However,
patients
who
are
set
to
benefit
most
cannot
apply
their
expenditures
on
drugs
purchased
through
these
platforms
to
their
health
insurance
out-of-pocket
contribution
requirements.
By
making
this
possible,
we
are
putting
patients
first
and
promoting
competition
to
drive
down
costs
further,”
Murphy
said
in
a
statement.
He
is
also
a
practicing
surgeon.
The
Council
for
Affordable
Health
Coverage
applauded
the
bill.
CAHC
is
an
advocacy
organization
focused
on
bringing
down
the
cost
of
healthcare.
“Affordability
is
the
defining
concern
for
Americans,”
said
Joel
White,
president
of
the
Council
for
Affordable
Health
Coverage.
“In
health
care,
it
determines
whether
patients
can
get
the
medicines
and
care
they
need
to
stay
healthy.
Congressman
Murphy’s
legislation
helps
remove
barriers
to
that
care
and
improve
health
outcomes.”
The
introduction
of
the
Every
Dollar
Counts
Act
comes
after
the
Trump
administration
launched
its
own
direct-to-consumer
drug
platform
called
TrumpRx
in
February.
It
offers
discounted
cash
prices
for
certain
brand-name
prescription
drugs
and
is
available
to
consumers
who
are
not
using
insurance.
However,
patients
can’t
directly
purchase
medications
on
TrumpRx.
Instead,
the
platform
connects
them
to
drug
manufacturer
websites
or
provides
coupons
for
retail
pharmacies.
Photo:
z_wei,
Getty
Images