State Limits on Patient Pharmaceutical Costs
White Paper
Aug 22, 2018
How state policies and regulations are addressing rising consumer drug spend and what that means for patients

To address increasing patient cost for drugs, policy makers have been particularly focused on the increasing cost-sharing burden on patients for more expensive specialty therapies. The Affordable Care Act established an annual maximum out-of-pocket cost limit for patients enrolled in non-grandfathered plans, indicating that this issue is recognized by the federal government. Some states have also enacted polices that seek to limit prescription drug cost-sharing for patients.

In this white paper, IQVIA examines the effects of such policies on patient costs, by investigating the policies implemented in Louisiana, California, and Colorado. These three states provide an opportunity to compare states with similar policies—Louisiana and California—to a state with a much different policy— Colorado. IQVIA’s US Market Access Strategy Consulting team is uniquely suited to measure the impact of such policies thanks to longitudinal claims data and experience analyzing patient cost-sharing trends.