Understand the Issue

Patients cannot afford prescription medications

Skyrocketing out-of-pocket costs put lifesaving medications out of reach for people with chronic conditions and communicable diseases. Many medications can cost a patient between 20-50% of the drug’s total cost each month, causing people living with arthritis, cancer, epilepsy, HIV and others to pay hundreds, even thousands, of dollars a month.

People living with chronic or life-threatening diseases should not be additionally burdened with exorbitant out-of-pocket costs for medications.

When the cost of medication becomes too high for someone who needs necessary treatment, they may stop taking the medicine or skip dosages, which oftentimes causes conditions to worsen and allows the illness to spread. This results in unhealthier communities and a rise in overall medical costs.

A number of states have passed laws that put a cap on these costs, including Delaware, Louisiana and Maryland (limits monthly out-of-pocket costs), New York (prohibits creating specialty drug tiers), Maine, Montana and Vermont (limits annual out-of-pocket costs). In 2015, legislation was introduced in California, Connecticut, Illinois, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Mississippi, Nevada, New Jersey, Ohio, Oregon, Pennsylvania, Virginia and Washington.

Over the past two years in Illinois, a number of bills have been introduced that proposed a monthly cap on out-of-pocket costs.  While there was a lot of attention and interest, these bills did not move in Springfield.

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