SOURCE: Lupus Foundation of America

Lupus Foundation of America

March 25, 2015 18:53 ET

People With Lupus Must Have Access to Prescription Drugs

WASHINGTON, DC--(Marketwired - March 25, 2015) -

Statement from Sandra C. Raymond, President and CEO of the Lupus Foundation of America

People with lupus need and deserve a full arsenal of treatments. With many new and innovative drugs for lupus in the drug pipeline, these highly anticipated treatments will mean nothing if people with lupus cannot afford them. The Patients' Access to Treatments Act (PATA), reintroduced in the House of Representatives, would give thousands of lupus patients access to life-saving treatments by lowering patient out-of-pocket costs for so-called "specialty drugs" in commercial health plans.

We were so happy to have Allie Gutshall at the press conference to reintroduce the legislation. Her lupus story and struggles in coverage with lupus medication is a real example of why we need to pass this bill.

Traditional prescription coverage puts medications on formulary tiers with a fixed dollar copayment for each tier. A small proportion of commercial health plans of health insurance companies have adopted a new pricing system with specialty tiers for expensive drugs, that requires patients to pay a percentage of the cost of the medication -- from 25 percent to 22 percent or more, often hundreds or thousands of dollars each month -- rather than a fixed co-payment amount. This practice is causing many patients to underutilize treatments or go without treatment at all. 

PATA would end the practice of discriminating between medications with a fixed co-pay and specialty drugs by requiring commercial health insurers to impose the same co-payment obligations for specialty drugs as they already do for other medications.

The Lupus Foundation of America is a founder and current co-chair of the Coalition for Accessible Treatments. The Coalition, whose members include more than 30 national patient advocacy and provider organizations, have come together to ensure that people with lupus and other chronic diseases have access to a full range of treatments. We must work together and tell the lupus story and urge Congress to pass this important bill.

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