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09/17/2024 06:32 AM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?SPick=20130&chamber=H&cosponId=12729
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House Co-Sponsorship Memoranda

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House of Representatives
Session of 2013 - 2014 Regular Session

MEMORANDUM

Posted: May 8, 2013 10:45 AM
From: Representative Jim Christiana
To: All House members
Subject: Specialty Tier Prescription Drugs Study
 
I am introducing a resolution directing the Legislative Budget and Finance Committee (LBFC) to conduct a study of specialty tier prescription drugs to determine the effect on access and patient care.

Specialty drugs are classified by Medicare as those costing more than $600 per month. They are commonly prescribed and often the most effective means to treat conditions such as hemophilia, human immunodeficiency virus (HIV), hepatitis, multiple sclerosis, lupus, some cancers, and rheumatoid arthritis, among others.

The number of specialty drugs is expected to grow more than 25 percent per year, both in increased utilization and increased unit cost. Many specialty drugs, including those known as biologics which are derived from living organisms, do not have a generic equivalent. In response, payers are shifting from prescription coverage with a fixed-dollar copay to coinsurance which requires a percentage of cost-sharing, typically 25 percent to 33 percent of the drug’s total cost.

This change can make drug treatments unaffordable to patients. For instances, two oral drugs released in May 2011, Incivek® (telaprevir) and Victrelis® (boceprevir), represent a true breakthrough for patients with hepatitis C. However, each round of treatment for these drugs costs between $24,000 and $50,000. Using conservative figures, one round of treatment of Incivek® would cost a patient at least $6,000 if it is within a specialty tier for their coinsurance.

My resolution directs LBFC to examine the effect specialty tier drugs are having on the care and treatment of patients.

Please join me in co-sponsoring this resolution. If you have any questions, please do not hesitate to contact me.




Introduced as HR348