Around the country, the National MS Society has been pushing legislation that would eliminate the use of specialty tiers or at least shed light on the increasing trend that pushes more costs onto people with chronic disease. In Alaska, we are supporting House Bill 218 which would increase the notification requirement before specialty tiers can be implemented to 90 days. Specialty tiers are a pricing mechanism that insurers use to charge people more money depending on the cost of a drug. For example, generic drugs are often on Tier 1 and require the lowest co-pay, maybe $5 per prescription. Preferred brand name drugs may be on Tier 2, and have a $20 co-pay. Tier 3 are non-preferred brand name drugs and may cost say $50. Drugs on a specialty tier (increasingly often the MS disease-modifying therapies), may have a 20% co-insurance charge. That percentage cost adds up real quick for an MS drug that costs $4,000 a month.
A recent segment on KTUU 2 in Alaska talks about the bill and it's impact on one Alaska family impacted by MS.