The Role of Pharmaceuticals in Health Insurance Exchanges
As part of the implementation of the Affordable Care Act, a series of state health insurance exchanges are being established across the United States. National Pharmaceutical Council Chief Science Officer Dr. Robert Dubois says there are several issues to watch as states choose benchmark plans that will define the standard set of benefits that must be covered by plans in that state.
As part of the implementation of the Affordable Care Act, a series of state health insurance exchanges are being established across the United States. National Pharmaceutical Council Chief Science Officer Dr. Robert Dubois says there are several issues to watch as states choose benchmark plans that will define the standard set of benefits that must be covered by plans in that state. In particular, he points to the level of choice doctors and patients will have in their selection of medications; concerns about reaching out of pocket spending maximums and the impact on patients; and how individual treatment effects will be considered in coverage decisions.
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Dr. Dubois will lead a panel discussion, "Capturing the Value of Pharmaceuticals--A Look at Rx Coverage and Cost in the New Health Insurance Exchanges," today at 4:30 p.m. during the Health Insurance Exchange Summit.
Dr. Dubois will be joined by Dave Domann, MS, RPh, Director Health Care Quality, Johnson & Johnson Health Care Systems Inc.; Caroline F. Pearson, Director, Avalere Health; and Mark Fendrick, MD, Professor, Department of Internal Medicine & Department of Health Management and Policy, University of Michigan, and Director, University of Michigan Center for Value-Based Insurance Design.