A RESOLUTION

 

1Directing the Legislative Budget and Finance Committee to study
2the issue of specialty tier prescription drug pricing in
3Pennsylvania.

4WHEREAS, Traditional prescription drug benefit plans include
5a multitiered drug formulary structure; for example, generic
6drugs are in the first tier, preferred brand name drugs are in
7tier two, nonpreferred brand drugs are in tier three and
8specialty tiers are typically the fourth or greater tier; and

9WHEREAS, Specialty tier drugs are commonly prescription drugs
10used to treat conditions such as hemophilia, human
11immunodeficiency virus (HIV), hepatitis, multiple sclerosis,
12lupus, some cancers, rheumatoid arthritis and others; and

13WHEREAS, The specialty tier changes the patient's cost from a
14fixed copayment to a coinsurance as a percent of the cost of the
15drug; and

16WHEREAS, A patient may pay a copayment which is increased
17with each tier but is a fixed amount for medications on the
18lower tiers of an insurance formulary; and

1WHEREAS, The specialty tiers require the patient to pay a
2coinsurance or percentage, 20% to 30% or more, of the drug cost;
3and

4WHEREAS, The number of specialty drugs is expected to grow
5more than 25% per year, both in increased utilization and
6increased unit cost; therefore be it

7RESOLVED, That the Legislative Budget and Finance Committee
8conduct a study of specialty tier prescription drugs to
9determine the impact on access and patient care; and be it
10further

11RESOLVED, That the committee report its findings and
12recommendations to the Senate no later than January 30, 2014.