SENATE CONCURRENT RESOLUTION NO. 71

(By Senators Hall, McCabe, Minard and Browning)

Requesting the Joint Committee on Government and Finance to study the impacts of cost sharing, coinsurance and specialty tier pricing for prescription medications.

    Whereas, In response to increasing prescription drug costs, many health plans and prescription drug plans have increased enrollee cost-sharing amounts, instituted coinsurance, and created specialty tiers, resulting in increased medication costs for patients participating in those plans; and

    Whereas, The National Conference of State Legislatures reports that between 2000 and 2009, copayments for insured workers have increased twenty-five percent for generic drugs, eighty percent for preferred drugs, fifty-nine percent for nonpreferred drugs, and forty-four percent for fourth-tier drugs or specialty tier drugs; and

    Whereas, Many health plans and prescription drug plans now require individuals to pay a coinsurance or percentage of the cost of fourth-tier or specialty tier prescription medications; and

    Whereas, Fourth-tier or specialty tier medications often include medications for chronic diseases, including certain types of cancer, hemophilia, multiple sclerosis, myositis, neuropathy, arthritis, human immunodeficiency virus, and other diseases and disorders; and

    Whereas, Coinsurance, cost-sharing, and specialty tier pricing place significant and onerous financial burdens upon insured individuals with chronic health care issues requiring prescription medication, in many cases leading to decreased adherence or failure to take medications as prescribed, resulting in acute incidents and negative health outcomes; therefore, be it

    Resolved by the Legislature of West Virginia:

    That the Joint Committee on Government and Finance is requested to study the impacts of cost sharing, coinsurance and specialty tier pricing for prescription medications; and, be it

    Further Resolved, That the study shall: (1) Determine the impact of cost sharing, coinsurance and specialty tier pricing on access to prescription medications for chronic health disorders; and (2) identify and evaluate options for reducing any negative impacts of cost sharing, coinsurance and specialty tier pricing, including but not limited to statutory limitations on cost sharing obligations for prescription medications; and, be it

    Further Resolved, That the Joint Committee on Government and Finance report to the Legislature on the first day of the regular session, 2012, on its findings, conclusions and recommendations, together with drafts of legislation necessary to effectuate its recommendations; and, be it

    Further Resolved, That the expense necessary to conduct this study, to prepare a report and to draft necessary legislation be paid from legislative appropriations to the Joint Committee on Government and Finance.