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Legislation May Improve Patient Access to Vital Medications
Date:3/20/2012

ATLANTA, March 20, 2012 /PRNewswire-USNewswire/ -- Cost-sharing practices that limit access to vital medications for people with serious health conditions may soon be alleviated for many patients thanks to a bill just introduced in Congress. The bi-partisan legislation, supported by the American College of Rheumatology, the Arthritis Foundation and other medical and patient groups, has been introduced by Rep. David B. McKinley (R-WV) and Rep. Lois Capps (D-Calif.).

The Patients' Access to Treatments Act of 2012 (H.R.4209) would limit co-payment, co-insurance or other cost-sharing requirements that insurance plans require for so-called "specialty" medications and make access to innovative and necessary medications more available to people with chronic, disabling or life-threatening conditions.

"Excessive cost sharing that prevents insured patients from accessing the medications they need is simply unacceptable," says Dr. James O'Dell, American College of Rheumatology president and rheumatology professor of internal medicine at the University of Nebraska Medical Center and the Omaha Veterans Affairs Medical Centers in Omaha, Neb. "We applaud the leadership of Reps. McKinley and Capps for their commitment to making sure more people can access the specialty medications that can prevent them from becoming disabled, seriously ill, or dying.  Their efforts today will help to reduce unnecessary surgeries, hospital and ER visits, as well as the high costs of long-term care for people whose health conditions worsen because they are not able to receive proper treatment."

Insurance plans are increasingly adopting a tiered prescription drug system that puts the most expensive medications into a higher specialty tier. Medications placed on a specialty tier require enrollees to pay a percent of the cost as opposed to a traditional co-pay. As a result, patients' out-of-pocket costs could run from several hundred to thousands of dolla
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SOURCE Arthritis Foundation
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