SAN FRANCISCO, Feb. 10, 2011 /PRNewswire/ -- Assemblymember Fiona Ma (D-San Francisco), the California Chapters of the National MS Society and the Alliance for Plasma Therapies today announced the introduction of new legislation that will eliminate so-called "specialty tiers" from health insurance coverage, and prevent insurers from shifting the cost of expensive medication to California patients.
"Specialty tiers dramatically increase the cost of vital medications, discriminate against the most vulnerable California patient populations, and jeopardize the health of Californians by placing the cost of medications beyond reach," said Assemblymember Fiona Ma. "AB 310 is common-sense patient protection legislation that will help ensure that no Californian ever has to choose between taking life-sustaining medication or paying rent and providing food for his or her children."
Commercial health plans in California have introduced discriminatory "specialty tier" cost structures. Rather than paying a flat rate for medication, Californians with medications on specialty tiers -- which include the most expensive medications -- can pay coinsurance of up to 35% of the total cost of the medication. For a patient with a chronic condition, the added financial burden of specialty tiers can be hundreds or thousands of dollars per month.
AB 310, sponsored by Assemblymember Fiona Ma, would eliminate specialty tier pricing for medication, place a cap on patient co-pays, and limit the annual out-of-pocket expenditures for California patients.
"The prohibitive cost of my MS therapy -- at one point almost $800 per month -- pushed me to stop taking my medication without any alternative therapy lined up," said Melanie Rowen, a San Francisco resident living with MS. "As someone living with MS, staying healthy means making sure I'm taking the most effective MS drugs available. I can't afford to wait and see what happens without my medication, because waiting means gambling with my future."
Although any Californian might be affected by specialty tiers, those patients most affected include Californians living with chronic illnesses such as multiple sclerosis, rheumatoid arthritis, hemophilia, and those with life-threatening conditions such as HIV, breast cancer, colorectal cancer and leukemia.
"Specialty tiers prevent patients living with neuropathy, MS and other chronic conditions from accessing life-saving and life-enhancing treatments, including plasma therapies," said Michelle Vogel, Executive Director of the Alliance for Plasma Therapies. "Specialty tiers undermine the original purpose of health insurance, which was spread and share health care costs. Specialty tiers do the exact opposite -- they pass the financial burden of health care on to the most vulnerable patients, while the healthy and health insurers pay less."
"For a Californian living with MS or another chronic condition, access to treatment is critical for improving both the quality and duration of life," said Stewart Ferry, Public Policy Director for the National Multiple Sclerosis Society. "The financial burden of paying for medication, particularly in tough economic times, would be a strain for anyone, but it has a potentially devastating impact for those Californians living with MS and other chronic conditions. For those Californians, the increased financial burden of specialty tiers will threaten the financial solvency of their families, and jeopardize the ability of some patients to take necessary medication."
Last year, New York became the first state to address this critical patient issue, passing a bill with broad bipartisan support that prohibited insurers from creating specialty tiers. Other states are now considering similar legislation.
About National MS Society
The National MS Society addresses the challenges of each person affected by MS by funding cutting-edge research, driving change through advocacy, facilitating professional education, collaborating with MS organizations around the world, and providing programs and services designed to help people with MS and their families move their lives forward. In 2009 alone, through its national office and 50-state network of chapters, the Society devoted over $132 million to programs that enhanced more than one million lives. The Society also invested nearly $36 million to support 375 research projects around the world. The Society is dedicated to achieving a world free of MS. www.nationalMSsociety.org
About The Alliance of Plasma Therapies
The Alliance for Plasma Therapies is a national non-profit organization established to provide a unified, powerful voice of patient organizations, healthcare providers and industry leaders to educate about the diseases that rely on plasma derived therapies and advocate for fair access to plasma therapies for patients who benefit from their lifesaving effects. www.plasmaalliance.org
SOURCE Alliance for Plasma Therapies