On June 22, 2017, Representatives David McKinley (R-WV) and G. K. Butterfield (D-NC) introduced the Patients’ Access to Treatment Act (H.R. 2999) – legislation that aims to ease the cost-sharing burden for patients in need of specialty prescription drugs.
The newly introduced bill calls for changes to the coinsurance rates for higher-cost, specialty-tier drugs, such as biologics and oral chemotherapy. Prescription drugs are usually categorized as generic, non-preferred, or preferred in cost-sharing tiers, with higher tiers consisting of expensive specialty drugs. For medications in these tiers, patients are often responsible for a percentage of the cost, rather than a fixed rate. Many of these treatments cost more than $10,000 a month, and co-insurance payments can run as high as 25 to 50 percent – creating a financial hardship for patients. 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, rather than requiring a co-insurance payment.
American Society of Hematology President Kenneth C. Anderson, MD, expressed support for 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.”
Source: ASH press release, June 23, 2017.