Drug Affordability
Save Our Benefits AZ is a patient advocacy network that supports transparency and innovation in healthcare. Our goal is to promote a robust, private prescription drug marketplace that ensures competition, drives down prescription drug costs, and provides affordable alternatives for patients. Our healthcare system works best when the focus is on the patient and not making a profit.
Government Mandates
The insurance industry is heavily regulated at every level: the federal government, state legislatures, and local municipalities. Every aspect, including accountability to the patient, health care premiums and claims, adequate networks, and benefit levels all are monitored and regulated. However, when special interests try to implement new mandates, they are often sacrificing patient care and price in order to improve their profit and bottom line. We generally opposes new health insurance mandates so we can keep costs affordable and protect your benefits.
“Gold Carding”
“Gold carding” is a practice that allows certain providers to circumvent the prior-authorization process. It presents significant challenges because it removes key checks and balances that are in place to ensure a patient receives the best, evidence-based care at the best possible cost. Where the practice has been implemented, gold carding has:
Raised costs to consumers because the program is difficult to implement;
Reduced quality and patient safety; and,
Reduced transparency within the health care system.
Gold carding ultimately raises costs and negatively impacts patient care, which is why Save Our Benefits AZ will continue to fight against it.
Supporting small business and hard-working families
Insurance cost increases hit individuals and small business the hardest. Save our Benefits AZ is fighting for the folks who don’t have the ability to show up at the Capitol and share their stories because they are busy creating jobs and putting food on the table for their family. We’ve all felt the pain of inflation and increased prices - so we will continue to combat mandates that restrict the ability to design high-quality, affordable plans that fit their budget. Our job creators and working families get hit the hardest when insurance costs go up, so we will continue to fight special interest mandates that negatively impact your business and family.
Biosimilars
Biosimilars are FDA-approved drugs that are highly similar to brand-name drugs. We value biosimilars and support efforts to bring them to market - the increased competition drives down the cost of drugs. Having multiple products, with equivalent patient benefits, provides an opportunity to push manufacturers to compete on pricing so patients receive the lowest cost, medically appropriate drugs. As production and licensing of biosimilar medications increases, health plans need the ability to adapt quickly and add those effective but less expensive biosimilars to their drug formulary so their customers can immediately benefit from the cost savings.
White Bagging
There’s a lot of jargon in the prescription drug and pharmacy distribution world, leaving many of us wondering what it all means. A good example is “white bagging.”
White bagging is when a specialty pharmacy safely and efficiently sends a patient’s prescription drug to the site of care where a clinician can administer it. The health plan reimburses the specialty pharmacy for the medication then reimburses the provider for administering the drug. There are many instances, such as chemotherapy treatment, where a patient may be required to visit a healthcare facility so their specialty drug can be safely administered and monitored by a health care provider.
Specialty medications generally require special storage and handling, are very expensive, have short shelf lives, and are for patients with rare or complex medical or disease conditions. These drugs cost less when they are distributed through a specialty pharmacy and billed through the prescription drug benefit rather than through the provider “buy and bill” method, where a provider purchases the drug, stores it, then bills the insurance plan at an unspecified - and often - huge markup.
White Bagging is essential to keeping specialty drugs affordable for those who desperately need them.
Legislative Transparency
Arizona law requires anyone seeking mandatory coverage of a drug or treatment to include a cost-benefit analysis along with a review of the social and financial impacts it may have. This gives policymakers more tools to properly evaluate the impact of a new coverage mandate. For example, House Bill 2622, a 2023 legislative proposal, would apply the existing process to any proposed cap on cost sharing. Cost sharing is a concept that sounds fair, however, when costs are statutorily capped on certain drugs, it ultimately puts limitations on future coverage and increases costs for all of the other health care customers.
Save Our Benefits AZ believes transparency in health care is beneficial to everyone, from the lawmakers who dictate the policy to the patient who ultimately pays for changes to insurance plan design.