Harrisburg – The Senate approved a measure sponsored by Sen. Bob Mensch (R-24) authorizing a study of specialty tier prescription drugs to determine the impact on access and patient care.
Senate Resolution 70 directs the Legislative Budget and Finance Committee (LBFC), chaired by Senator Mensch, to conduct the study.
Specialty drugs are classified by Medicare as those costing more than $600 per month and often the most effective means to treat conditions such as hemophilia, (HIV), multiple sclerosis, lupus, some cancers, and rheumatoid arthritis, among others.
“Many specialty drugs 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,” said Mensch. “This change can make drug treatments unaffordable to patients.”
As an example, Mensch cited two new oral drugs, IncivekTM (telaprevir) and VictrelisTM (boceprevir), which represent a 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.
“The number of specialty drugs is expected to grow more than 25 percent per year, in both increased use and increased cost,” said Mensch. “The LBFC study will help shed light on the growing problem of affordability and access, and allow policymakers to explore solutions.”
Under Senate Resolution 70, the LBFC will report its findings to the Senate by July 15, 2014.