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Easier Access to Rare Disease Drugs in Insurance

This act aims to facilitate access to drugs for rare diseases for individuals covered by Medicare, Medicaid, and private health plans. It changes the rules by which insurers decide on drug coverage, introducing new criteria based on medical literature. This allows patients with rare conditions to obtain necessary treatment more quickly.
Key points
Expands the list of information sources Medicare and Medicaid use to cover rare disease drugs, including peer-reviewed medical literature.
Introduces expedited review processes for rare disease drug coverage requests by private health insurance plans.
Facilitates access to drugs for individuals suffering from conditions affecting 200,000 or fewer people in the United States.
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Additional Information
Providing Realistic Opportunity To Equal and Comparable Treatment for Rare Act
Print number: HR 6094
Sponsor: Rep. Matsui, Doris O. [D-CA-7]
Process start date: 2023-10-26