ObamaCare Bows To Big Pharma – Backtracks On Rx Rules

The government backtracked from an initial proposal made in December that would have let health plans cover as few as one drug per class of medicine, a move opposed by drugmakers and patient-advocacy groups that argued it would limit choices.

The federal government instead proposed that insurers can cover the same number of drugs per class as state benchmark plans, which are typically greater than the single-drug option the Obama administration had considered. The change is a win for pharmaceutical companies, which had lobbied for coverage of more medicines, said Dan Mendelson, chief executive officer of Avalere Health LLC, a Washington-based consulting company.