Patient Pocket Calculator

A great example of partnership working for the benefit of patients that in principle could be replicated across any health care system.

The Patient Pocket Protector Coalition (PPPC) works with state legislators to introduce patient-first policies addressing the financial burdens of the 133 million Americans living with chronic illnesses, beginning with pharmacy benefit manager (PBM) rebate reform.

To ensure that proposed legislation achieves their goal of protecting patients’ pockets, the PPPC are prioritizing the following thresholds for bills addressing PBM rebate reform:

• A minimum of 80% of rebates and discounts must be passed through to patients at the point of sale

• All co-pays that are a percentage of price must be calculated based on the price net of rebates and discounts

• Civil penalty per violation to be levied by the state department of insurance or other entity for noncompliance by an insurer.

Chronic illnesses account for 75 percent of the $2.2 trillion people spend on health care each year in the U.S. and unchecked PBM practices add to costly life-saving drugs needed by patients.