Given that treatment adherence is hard enough for some folks as it, and that adherence to a drug regimen a) prolongs the life of PWAs and b) likely prevents new HIV infections by lowering the viral loads of HIV-positive people, Blue Cross has so much blood on its hands. Can we get a phone zap up in here?
Once again, Blue Cross has created a new “tier” of pharmacy benefits – Tier 4, a.k.a. “specialty” drugs a.k.a. a long list of medications for the treatment of HIV (they’ve included a few cancer and other drugs as well – though literally every single medication used for the treatment of HIV is now Tier 4) and for which there are no alternative or generic medications.
And what is different about this tier? Well, rather than a standard co-pay (it was $30.00 per prescription in 2012), patients are required to pay 20% of the cost of the medication or $150 maximum. Since all of the medications are expensive, the bottom line is that most co-payments are $150 or close to it, i.e. a 400% increase in out-of-pocket expenses for those being treated for HIV. In other words, Blue Cross has specifically targeted their most vulnerable patients as a new source…
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