Traditionally health insurance plans have charged fixed co-pays for different tiers of medications: generics (Tier I), name brands (Tier II), and off formulary medications (Tier III). Each tier has a set co-pay such as $10, $20 or $50. Unfortunately, some health insurance policies are moving vital medications, mostly biologic medications, into "specialty tiers" that utilize high patient cost-sharing methods or co-insurance. This fourth tier now commonly requires patients to pay a percentage of the cost of medication – from 25% to 33% or more, often hundreds or thousands of dollars each month – rather than a fixed co-payment amount.
U.S. Representative David McKinley (R-WV) has agreed to introduce legislation later this month, known as the Patient Access to Critical Therapies Act (PACTA), to end this discrimination by requiring insurers to impose the same co-pay obligations for Tier IV/specialty drugs, such as biologics, as they do for Tier III medications.
Rep. McKinley has agreed to be the lead sponsor for PACTA and he needs your help getting other Members of Congress to support this legislation.
You can help get co-sponsors for PACTA! Please click here to send a pre-written letter to your U.S. Representative to ask them to be an original co-sponsor of this legislation.
I encourage you to edit the letter to share your story of how high-cost sharing of medications have affected your life.
Thanks for posting this, Adrienne. I personalized one of these letters yesterday and sent it off to my congressman.
ReplyDeleteI wonder if the ACA will stop this sort of pharma-gouging?
Seems like anything to make a buck! Wonder if they would feel that way if it were their wife or child suffering...
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