Governor’s signature reins in medication costs for serious health conditions

July 30, 2013

Legislation signed by Gov. Jack Markell places limits on the costs to Delawareans for prescription drugs that treat many major health problems. The final provisions of the law reflected hard work by many different groups within the healthcare community, whom the governor thanked for coming together to protect the affordability of these medicines.

In addition to the Delaware Health Care Commission, which researched the effects of pricing on patient access and care, other groups and organizations involved included the National Hemophilia Foundation, Arthritis Foundation Mid-Atlantic Region, National MS Society - Delaware Chapter, Limestone Medical, Medical Society of Delaware, HIV Consortium, Pfizer and Highmark Blue Cross Blue Shield of Delaware. Many representatives from these groups joined the governor in his office for the bill-signing ceremony.

By restraining co-insurance and copayment fees for specialty tier medications, Senate Bill 35 can drastically reduce the amount that patients will be expected to spend to receive the specialized and consequently quite expensive medications that are necessary for the treatment of their serious, long-term health conditions.

“Many of us know someone who is suffering from serious, long-term health conditions such as hemophilia, HIV, hepatitis, multiple sclerosis, and lupus, and we are aware of the high personal expense associated with receiving treatment for such conditions,” said Markell. “For Delawareans who are facing challenges like these, this bill will ensure they will not be unfairly denied access to prescription drugs because of increasing costs, and that in purchasing these life-enabling medications neither they nor their families will be forced to endure severe financial strain.”

Under the law, a patient’s co-insurance or copayment fees for specialty tier drugs will be limited to $150 per month for up to a 30-day supply of any single specialty tier drug. Patients will also be able to request an exception to obtain a specialty drug that would not otherwise be available on a health plan formulary. The bill goes into effect Jan. 1, 2014.

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