FOR IMMEDIATE RELEASE
April 1, 2015
Keeping Treatment in Reach
‘Rx in Reach’ Campaign Launches to Limit Out-Of-Pocket Costs for Critical & Life-Saving Medications in Georgia
Advocates for Responsible Care, Specialty Tiers Coalition of Georgia & Other Patient Groups are Calling for Legislation to End Medication Price Discrimination for Insured Georgians
ATLANTA, GA. (March 31, 2015) – Advocates for Responsible Care, a non-profit alliance of Georgia health care professionals, patient advocates and human rights specialists, today announced the launch of Rx in Reach – a new campaign to limit rising out-of-pocket costs for insured Georgia families. Led by Advocates for Responsible Care, in partnership with the Specialty Tiers Coalition of Georgia and other leading patient and provider groups across the state, the goal of the Rx in Reach campaign is to raise awareness about the devastating impact of so-called “specialty tier” price structures and to advocate for state legislation which caps the amount that health insurers can charge patients out-of-pocket for critical and life-saving medications.
“Critical treatments for cancer, arthritis, multiple sclerosis and other serious conditions are out of reach for a growing number of insured Georgia families,” said Dorothy Leone-Glasser, RN, HHC, Executive Director of Advocates for Responsible Care. “Health insurers are increasingly moving medications onto formulary tiers where there is no limit to what patients must pay out-of-pocket. As a result, many Georgia families are either struggling to afford treatment or living in fear that the medications they need will soon be out of reach.”
Leone-Glasser continued, “Georgia families pay their health insurance premiums expecting affordable treatment when they need it. Instead of honoring the promise of accessible care, health insurers are increasingly discriminating against the most vulnerable patients by charging hundreds or even thousands of dollars per month for a single medication. Georgia needs legislation to limit out-of-pocket costs and ensure that families that pay their health insurance premiums can access treatment when they need it most.”
Prescription drug benefit plans traditionally include a three-tiered drug formulary, with copay limits for each tier. Insurance companies, however, are increasingly moving medications onto “specialty tiers,” where there are no limits on what the patient is required to pay. Instead of a manageable, fixed copay, patients whose medications are placed on a specialty tier may be forced to pay 20-50 percent or more of the total drug cost each time they fill a prescription.
Although anyone in Georgia could be subjected to unreasonably high out-of-pocket costs, those most likely to be affected are living with life-threatening or chronic conditions, such as cancer, rheumatoid arthritis, multiple sclerosis, hemophilia, epilepsy, lupus, and HIV/AIDS.
Rx in Reach is advocating for legislation limiting the copay or coinsurance for specialty tiers medications to $150 for a 30-day supply. Several states across the country, including New York, Vermont, Maine, Delaware, Maryland, Louisiana and Montana, have already implemented similar limitations.
About Advocates for Responsible Care
Advocates for Responsible Care (ARxC) is a non-profit organization that functions as an alliance of health care professionals, patient advocates, and human rights specialists to advance ARxC’s mission to reduce cultural incompetency and health care delivery disparity. We offer services to inform the public, mobilize support, and implement strategies to address the inequitable delivery of health care services in Georgia.
About the Specialty Tiers Coalition of Georgia
The Specialty Tier Coalition of Georgia was started in September 2011 to give a voice to Georgians who struggle with affordable access to their specialty medications. The coalition has 20 health-centered organizations as members joining efforts to advocate for legislation that ends the financial and discriminatory barriers to securing these drugs. To date, eighteen (18) states have taken action to protect patients who must take specialty tier medications. The Specialty Tiers Coalition of Georgia urges members of Georgia’s General Assembly to pass legislation that will protect patients and ensure affordable access to lifesaving drugs.