PAP 2024: John Hoffman Discusses the Health Equity Spotlight Panel


In an interview with Pharma Commerce Associate Editor Don Tracy, John Hoffman, Principal, Advocate for Success, LLC talks about his 'Health Equity Spotlight' panel and advocacy accomplishments.

PC: As part of PAP 2024, you were a panel speaker during the ‘Health Equity Spotlight’ presentation. Can you provide us with a brief synopsis of what the session entailed?

Hoffman: We had myself, Austen Williams of Medi, and moderator Matt Toresco of Archo Advocacy. What we really wanted to do was provide awareness and education about why health disparities exist and clarification of the different definitions of health disparities, social determinants of health and health equity. Most importantly, what resources are available and what are the reasons that certain underserved populations don't get access not only to the care they need, but also are not aware of and don't get access to all the community services that are available to them.

PC: In your over 20 years of advocating for policies supporting patient healthcare, what do you believe has been your biggest accomplishment?

Hoffman: I think there are two. First, back in the Medicare Modernization Act, they changed from Part B providers getting reimbursed from average wholesale price for the drug to average selling price, which was a much lower reimbursement on buying and building the drug. Under the average wholesale price, they made enough money there that it compensated for the fact that they were being under-reimbursed for the actual administration of the infusion. When they were going to change that, we worked with patient groups, physician groups, and Congress to convince them that they needed to create a different administration code for providers of Part B drugs. It really got a lot of attention because it was all about trying to convince Congress that the codes were not a provider reimbursement issue, they were actually a patient access issue. The second is really looking at some of the practices that the pharmacy benefit managers put in to basically divert copay assistance from the patient to themselves, whether those are accumulator programs or maximizer programs. Now they call them alternative funding programs, but we've been able to get 20 states now to pass laws to make those programs illegal at the state level, and we're working to support federal legislation which would make them illegal at the federal level.

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