Specialty tier prescription drug coverage bill becomes law
Wilmington, DE – Legislation signed today by Governor Jack Markell places limits on the costs to Delawareans’ for prescription drugs that treat many major health problems. The final provisions of the law reflected hard work by many different groups within the health care community, who the Governor thanked for coming together to protect the affordability of these medicines. In addition to the Delaware Health Care Commission, which researched the effects of pricing on patient access and care, other groups and organizations involved included the National Hemophilia Foundation, Arthritis Foundation Mid-Atlantic Region, National MS Society – Delaware Chapter, Limestone Medical, Medical Society of Delaware, HIV Consortium, Pfizer and Highmark Blue Cross Blue Shield of Delaware. Many representatives from these groups joined the Governor in his office for the bill signing ceremony.
By restraining co-insurance and co-payment fees for specialty tier medications, Senate Bill 35 can drastically reduce the amount that patients will be expected to spend to receive the specialized, and consequently quite-expensive, medications that are necessary for the treatment of their serious long-term health conditions.
“Many of us know someone who is suffering from serious long-term health conditions such as hemophilia, HIV, hepatitis, multiple sclerosis, and lupus, and we are aware of the high personal expense associated with receiving treatment for such conditions,” said Governor Markell. “For Delawareans who are facing challenges like these, this bill will ensure they will not be unfairly denied access to prescription drugs because of increasing costs, and that in purchasing these life enabling medications neither they, nor their families will be forced to endure severe financial strain.”
Under the law a patient’s co-insurance or co-payment fees for specialty tier drugs will be limited to $150 per month for up to a 30-day supply of any single specialty tier drug. Patients will also be able to request an exception to obtain a specialty drug that would not otherwise be available on a health plan formulary. The bill goes into effect on January 1, 2014.
“This is helping make health care affordable for people by containing the cost of specialty drugs. Those drugs could cost thousands of dollars a month and those costs hurt families and could force people from their homes,” said Senate Majority Whip Margaret Rose Henry, D-Wilmington East, who sponsored SB 35 and led the fight for the law. “With this law, we are making the costs more affordable and helping people not only live longer, but to have better quality of life.”
Rep. Helene Keeley, a prime House sponsor of SB 35 and a board members of AIDS Delaware, said that many residents cannot afford escalating co-pays for prescriptions, which can lead to some not getting the medication they need to combat serious viruses and diseases.
“No Delawarean who has HIV, multiple sclerosis or cancer should be priced out of receiving the life-saving prescriptions they need to recover or simply survive,” said Rep. Keeley, D-Wilmington South. “By limiting the amount that patients can be charged for these specialty tier drugs, we are making it easier for them to access this medication and receive the treatment they need.”
Photos from the bill signing are available on Flickr.