Drug price increase during the year
May 09, 2022
Kaiser Health News published an article about a patient whose drug costs changed after selecting a drug plan. Although the article is about a Medicare drug plan, the possibility seems to be relevant to all insurance plans. This dynamic is unfortunate for the patient, who might select a plan during open enrollment because of drug pricing specifically relevant to him or her, only to discover that the prices change before the next opportunity to change insurance plans. Insurers would probably respond that they do not set drug prices, and therefore should not be held responsible for price increases.
Changing drug prices during a year seems to contrast with how insurers negotiate year-long (or multi-year) contracts with healthcare providers. Hence, office visits and procedures seem like they might be more stable in price during a single year. Theoretically, insurers could also negotiate annual terms for drugs, making their pricing stable. In this case, it appears that the insurer in question might have supplied incorrect information to Medicare's Plan Finder. If the insurer supplied incorrect pricing information, then it does seem that they should be held responsible for the price difference since the patient in the article selected the plan based on that information and cannot change plan selection during the year. Another policy change that could be more patient-friendly is to require insurers give 30 days' or 60 days' notice of price changes of relevant drugs and allow patients to change plans in the case of price increases.