Spanberger, Gonzalez Introduce Bill to Financially Protect COVID-19 Patients, Prevent Antibody Therapy Out-of-Pocket Costs

Jan 27, 2021
Healthcare
Press

WASHINGTON, D.C. – U.S. Representatives Abigail Spanberger (D-VA-07) and Anthony Gonzalez (R-OH-16) yesterday introduced the Protecting Patient Access to Lifesaving COVID-19 Drugs Act, legislation that would expand access to lifesaving COVID-19 treatments by requiring private health insurance plans to cover the administration costs of monoclonal antibodies without cost-sharing.

Authorized by the Food and Drug Administration in November 2020, monoclonal antibodies have proven to prevent COVID-19 infections and reduce COVID-19 related hospitalizations. The U.S. Department of Health and Human Services purchased 950,000 doses from Eli Lilly and another 300,000 doses from Regeneron. While these drugs will be distributed at no cost to patients, providers are able to charge an administration fee for the intravenous infusion of the antibodies – a service that can cost well over $1,000.

The Protecting Patient Access to Lifesaving COVID-19 Drugs Act would prevent COVID-19 patients from facing steep out-of-pocket costs as they battle the virus. Additionally, the bill would require insurers to reimburse any provider an amount that equals the negotiated rate or, if the plan or issuer does not have a negotiated rate with the provider, the cash price posted on the provider’s website.

“I’ve heard directly from Central Virginians concerned about the potential for high financial costs associated with COVID-19 antibody therapies, which are very expensive and require specialized professionals to administer them. To protect consumers on private plans from these high costs, our legislation makes clear that private plans must cover antibody therapies and infusions with no cost-sharing – just as they would cover COVID-19 testing,” said Spanberger. “This bipartisan effort responds to the urgency of our current crisis, and I’d like to thank Congressman Gonzalez for his partnership on this bill. As millions of Americans are treated for COVID-19 – and millions more are vaccinated against contracting the virus – our first priority must be to make sure no American is forced to decline necessary healthcare measures, simply because they fear potential costs. Our recovery as a nation will be stronger when all Americans are able to protect themselves and their families.”

“Monoclonal antibodies are the only COVID-19 therapy that have consistently proven they can save lives and reduce the strain on our hospitals,” Gonzalez said. “When seeking access to these lifesaving drugs, the last thing a patient should worry about is how they will pay for them. By guaranteeing coverage and eliminating cost-sharing, my bill ensures monoclonal antibodies are affordable and accessible to every American who needs them.”

“Cleveland Clinic applauds Representatives Gonzalez and Spanberger for introducing this important piece of legislation today. Throughout this pandemic, healthcare providers have continued to search for effective treatments for those suffering with COVID-19.  Monoclonal antibodies treatment has been one of the successful therapies. Expanding access to monoclonal antibodies to treat COVID-19 will be life-saving for many patients,” said Cleveland Clinic.

“Until a sufficient proportion of the population is vaccinated to achieve herd immunity, monoclonal antibodies for COVID-positive patients provide hope in reducing hospitalizations among high-risk patients and saving lives. Ensuring adequate insurance coverage will be critical to accessing these life-saving therapies,” said Brian Nyquist, President & CEO, National Infusion Center Association.

Click here to read the full bill text.

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