HIV medications and Mail order pharmacies
Jul 9, 2012
New York State recently passed the "NYS anti mandatory mail order law" which prevents health insurance companies from forcing patients to use mail order pharmacies for maintenance medications. I've recently heard rumors that they are trying to amend the new law in order to exclude certain high cost drugs (such as HIV medications as well as some other high cost maintenance medications) due to potential cost benefits. That change would mandate HIV patients to use mail order pharmacies. Are there certain states that already allow Insurance companies to force patients to use mail order pharmacies for HIV drugs and do you think that New York State will go in that direction ?
Response from Mr. Chambers
I'm not aware of any states other than NY that have prohibited forcing patients to purchase their medications through mail order pharmacies, and I didn't find any evidence there is a concerted effort to amend that law. However, I'm sure the fight isn't over yet.
Since insurers have ownership stakes in some of the mail order pharmacies, it is natural they want to push their insureds to use these any way they can as it further adds to their already record profits.
Where insurers have attempted to require use of mail order pharmacies is being strongly resisted wherever it appears. The National Community Pharmacies Association is taking an active role in lobbying to prevent such mandates, and there are sites advocating for the right of patients to use their neighborhood pharmacies, see http://www.fight4rx.org/ for example.
In addition, patients are rallying to support their pharmacists. This is especially true in the HIV community, where their pharmacies have literally given them their life back. Because ADAP rules do not permit using pharmacies out of state, that is another great incentive for persons with HIV/AIDS to become very vocal if such proposals are made in state legislatures. This is something that patients should discuss with their pharmacist. They will know what action, if any, is taking place in their state.
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