HR0450ham001 97TH GENERAL ASSEMBLY

HR0450HAM001 LRB097 12219 RPM 58995 a

AMENDMENT TO HOUSE RESOLUTION 450

AMENDMENT NO. ___. Amend House Resolution 450 by replacing everything after the title with the following:

"WHEREAS, In response to increasing prescription drug costs, many employer health plans and employer prescription drug plans have increased enrollee cost-sharing amounts, instituted coinsurance, and created specialty tiers; and

WHEREAS, The increase in price of specialty prescription drugs of 19.6% in 2010 versus a 1.4% increase for traditional drugs and the expected increase of specialty drugs of an additional 27.5% by 2013 creates significant financial pressures on employer health plans, employer prescription drug plans, and individuals who purchase an individual health insurance policy; and

WHEREAS, The National Conference of State Legislatures reports that between the years 2000 and 2009, copayments for insured workers have increased for specialty-tier drugs; and

WHEREAS, Medicare has used specialty tiers since 2006 to help control prescription drug costs on behalf of taxpayers; and

WHEREAS, Nationally 11% of employers utilize a coinsurance or percentage of the cost of fourth-tier or specialty-tier prescription medications to help control the cost of their prescription drug benefit plans; 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, Specialty-tier benefits and step therapy are strategies offered by employer health plans and employer prescription drug plans to incentivize plan participants to utilize lower cost generics or preferred brand alternatives; 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 HOUSE OF REPRESENTATIVES OF THE NINETY-SEVENTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that the Department of Insurance is requested to study the cost of specialty drugs and the availability and accessibility of manufacturer discounts and assistance plans to individuals and employers; and be it further

RESOLVED, That the study shall (1) determine the impacts of cost sharing, coinsurance, and specialty-tier pricing for prescription medications on individuals and employer health plans; (2) determine the percentage of small employers in Illinois providing prescription drug benefits and the impact of the high cost of specialty drugs on the ability of small employers and individuals to continue such prescription drug benefits; (3) identify and evaluate options for reducing the cost of specialty drugs on individuals and small employers; and be it further

RESOLVED, That the Department of Insurance shall report to the General Assembly 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 a suitable copy of this resolution be presented to the Director of Insurance.".