Specialty Tiers
On September 13, 2011 a groups of 17 organizations came together to form the Specialty Tiers Coalition of Georgia. This Coalition consists of patient advocates who attended a briefing hosted and facilitated by the Advocates for Responsible Care (ARxC) and Georgia Bio to learn more about the impact of insurance industries Specialty Tier categories of drugs on access to medications and learn how this practice is currently impacting Georgia.
The Specialty Tiers Coalition members are already addressing legislators on the dangers of SpecialtyTiers cost-shifting which will raise the medication cost of these Tier 4 & 5 & 6 drugs up to 33%. This will be an out of pocket cost to patients.
The Specialty Tiers Coalition has written a letter to the Pharmacy Caucus asking for their support to stop this cost-shifting and discriminatory practice that will make these life-saving, life-enhancing medications prohibitive for patients.
The Advocates for Responsible Care and Arthritis Foundation, SE Region have initiated a Call to Action for all Georgians. We are seeking patient stories from individuals who are taking Specialty Tier medications, and having difficulty paying the monthly cost, as set by their health plan. We also want to hear from patients about how this growing trend of increasing patient cost will affect their quality of life.
The Coalition will continue its efforts to ask for legislation that will allow all Georgians to have full access to their medications without imposing drug tiers based on expense or disease categories.
Respond to this CALL TO ACTION. Stop the increase in cost of specialty tier drugs.
1. Know the facts. Read the Specialty Tiers Coalition of Georgia's fact sheet "Specialty Tiers: What do they mean to Georgia?" to know the facts about specialty tiers and how they restrict access to medication for patients with chronic diseases.
2. Share your story. Tell the Georgia community how the increase in the cost of medication due to the specialty tier classification has impacted you or your loved ones. Share your story on the Specialty Tiers Story Submission webpage or email your story directly to ARxC at
dlg@wisdomofwellnessproject.com. If you have any questions or concerns please contact ARxC at 404-633-5843.
Unsure what to say in your story? Read Heidi's Story for an example of how specialty tiers could affect Heidi's ability to manage her Rheumatoid Arthritis.
4. Support our efforts. Help to mobilize the Georgia-wide effort by donating to ARxC. Go to our donation page to make your tax-deductible contribution today.
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ARxC and the Specialty Tier Coalition supports Representative Hank Johnson and his Medicare legislation on specialty tiers.
Ask your federal representative to vote in favor of Representative Johnson's legislation to end the rise in cost of medications for the chronically ill.
More information available at:
- Rep. Johnson to Medicare: Clarify why 'specialty tier' drug threshold remains $600
- Rep. Johnson seeks relief for chronically ill seniors
ARxC Specialty Tier Publications:
- ARxC factsheet - Specialty Tiers: What do they mean to Georgia?
- January 2012 Specialty Tier Coalition Update
- ARxC Specialty Tier Story Appeal
- Lifesaving drugs 'out of reach' for many - Georgia Health News, Andy Miller - September 12, 2011
- Workers Squeezed As Employers Pass Along High Costs of Specialty Drugs - Kaiser Health News and USA Today - August 22, 2011
- State Bills Setting Specialty Tier Limits Await Health Reform Developments - The Pink Sheet - August 22, 2011
- Specialty tiers deny fair health care - Coastal Courier Guest Columnist, Dorothy Leone-Glasser - August 17, 2011
- Insurers raising co-pays for expensive drugs - Sun Sentinel - August 15, 2011
- Specialty Tiers: Unequal Treatment - National Minority Quality Forum (Issue Brief 3) - August 9, 2011
- “Substantial Percentage” of Medicare Beneficiaries Are Uninformed on Out-of-Pocket Costs for Specialty Tier Prescription Drugs - Insurance News - August 9, 2011
- Specialty Tiers/Coinsurance Position Statement - SE Region Advocacy Volunteer Chair - Arthritis Foundation - August 8, 2011
- Landmark Patient Protection Legislation to End "Specialty Tier" Health Insurance Coverage Passes in California Assembly Health Committee - National Multiple Sclerosis Society, Northern California Chapter - May 4, 2011
- Bill aims to stop specialty tiers prescription drugs ABC N
- WGME 13 Top Story "Move Underway in Maine to Stop Insurance Companies from Passing Medication Costs Back to Consumers"
- Sun Sentinel's report "Patients with insurance hikes can not receive proper IV drugs."
http://www.freedigitalphotos.net/images/view_photog.php?/Image: renjith krishnan / FreeDigitalPhotos.net
