(WASHINGTON, June 23, 2017) Yesterday, Representatives David McKinley (R-WV) and G. K. Butterfield (D-NC) introduced the Patients Access to Treatment Act (H.R. 2999) in the House of Representatives. The legislation aims to remove the burden of excessive cost sharing for Americans who need high-cost, specialty-tier medications. As background, many insurance companies divide prescription medications into cost-sharing tiers, often designated by generic, preferred, and non-preferred status. Patients using drugs placed in the lower tiers, often tiers 1, 2, and 3, are usually charged a fixed co-pay. Increasingly, insurers, are moving higher cost drugs, like biologics and oral chemotherapy, into specialty tiers, often tiers 4 and 5. For medications in these tiers, patients are often responsible for a percentage of the cost rather than a fixed rate; this is known as coinsurance. These treatments can cost in excess of $10,000 a month, and can have coinsurance payments as high as 25 to 50 percent. The Patients Access to Treatment Act would require a fixed co-pay for specialty tier drugs that is in line with the highest non-preferred tier. ASH President Kenneth C. Anderson, MD, of the Dana-Farber Cancer Institute, issued the following statement in support of the legislation: The Patients Access to Treatment Act is an important first step toward ensuring that high-cost specialty medications are affordable for patients with blood diseases like hemophilia, leukemia, and multiple myeloma. While these therapies have drastically improved quality of life for patients with these disorders, they do little to help when placed financially out of reach. By making these life-saving therapies more affordable, this legislation will help eliminate the heartbreaking choice many patients face between confronting serious health complications and extreme financial hardship. This bill could also help avoid high long-term health care costs, disability, and death associated with treatment non-adherence. ASH looks forward to working with members of the House and Senate to ensure that this sensible legislation is passed swiftly."
The American Society of Hematology (ASH) (www.hematology.org) is the worlds largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment, and prevention of disorders affecting the blood. For more than 50 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology. ASH publishes Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field, which is available weekly in print and online. In 2016, ASH launched Blood Advances (www.bloodadvances.org), an online, peer-reviewed open-access journal. Contact: Stephen Fitzmaurice American Society of Hematology email@example.com; 202-552-4927
about the author
MyelomaCrowd Editorial Contributor. Daughter to a parent with cancer.