HR0450HAM001LRB097 12219 RPM 58995 a

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AMENDMENT TO HOUSE RESOLUTION 450

2    AMENDMENT NO. ___. Amend House Resolution 450 by replacing
3everything after the title with the following:
 
4    "WHEREAS, In response to increasing prescription drug
5costs, many employer health plans and employer prescription
6drug plans have increased enrollee cost-sharing amounts,
7instituted coinsurance, and created specialty tiers; and
 
8    WHEREAS, The increase in price of specialty prescription
9drugs of 19.6% in 2010 versus a 1.4% increase for traditional
10drugs and the expected increase of specialty drugs of an
11additional 27.5% by 2013 creates significant financial
12pressures on employer health plans, employer prescription drug
13plans, and individuals who purchase an individual health
14insurance policy; and
 
15    WHEREAS, The National Conference of State Legislatures

 

 

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1reports that between the years 2000 and 2009, copayments for
2insured workers have increased for specialty-tier drugs; and
 
3    WHEREAS, Medicare has used specialty tiers since 2006 to
4help control prescription drug costs on behalf of taxpayers;
5and
 
6    WHEREAS, Nationally 11% of employers utilize a coinsurance
7or percentage of the cost of fourth-tier or specialty-tier
8prescription medications to help control the cost of their
9prescription drug benefit plans; and
 
10    WHEREAS, Fourth-tier or specialty-tier medications often
11include medications for chronic diseases, including certain
12types of cancer, hemophilia, multiple sclerosis, myositis,
13neuropathy, arthritis, human immunodeficiency virus, and other
14diseases and disorders; and
 
15    WHEREAS, Specialty-tier benefits and step therapy are
16strategies offered by employer health plans and employer
17prescription drug plans to incentivize plan participants to
18utilize lower cost generics or preferred brand alternatives;
19and
 
20    WHEREAS, Coinsurance, cost-sharing, and specialty-tier
21pricing place significant and onerous financial burdens upon

 

 

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1insured individuals with chronic health care issues requiring
2prescription medication, in many cases leading to decreased
3adherence or failure to take medications as prescribed,
4resulting in acute incidents and negative health outcomes;
5therefore, be it
 
6    RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE
7NINETY-SEVENTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that
8the Department of Insurance is requested to study the cost of
9specialty drugs and the availability and accessibility of
10manufacturer discounts and assistance plans to individuals and
11employers; and be it further
 
12     RESOLVED, That the study shall (1) determine the impacts
13of cost sharing, coinsurance, and specialty-tier pricing for
14prescription medications on individuals and employer health
15plans; (2) determine the percentage of small employers in
16Illinois providing prescription drug benefits and the impact of
17the high cost of specialty drugs on the ability of small
18employers and individuals to continue such prescription drug
19benefits; (3) identify and evaluate options for reducing the
20cost of specialty drugs on individuals and small employers; and
21be it further
 
22    RESOLVED, That the Department of Insurance shall report to
23the General Assembly on the first day of the regular session,

 

 

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12012, on its findings, conclusions, and recommendations
2together with drafts of legislation necessary to effectuate its
3recommendations; and be it further
 
4    RESOLVED, That a suitable copy of this resolution be
5presented to the Director of Insurance.".