1Directing the Legislative Budget and Finance Committee to study
2the issue of specialty tier prescription drug pricing in
3Pennsylvania.

4WHEREAS, Traditional prescription drug benefit plans include
5a multitiered drug formulary structure; for example, generic
6drugs are in the first tier, preferred brand name drugs are in
7tier two, nonpreferred brand drugs are in tier three and
8specialty tiers are typically the fourth or greater tier; and

9WHEREAS, Specialty tier drugs are commonly prescription drugs
10used to treat conditions such as hemophilia, human
11immunodeficiency virus (HIV), hepatitis, multiple sclerosis,
12lupus, some cancers, rheumatoid arthritis and others; and

13WHEREAS, The specialty tier changes the patient's cost from a
14fixed copayment to a coinsurance as a percent of the cost of the
15drug; and

16WHEREAS, A patient may pay a copayment which is increased
17with each tier but is a fixed amount for medications on the

1lower tiers of an insurance formulary; and

2WHEREAS, The specialty tiers require the patient to pay a
3coinsurance or percentage, 20% to 30% or more, of the drug cost;
4and

5WHEREAS, The number of specialty drugs is expected to grow
6more than 25% per year, both in increased utilization and
7increased unit cost; therefore be it

8RESOLVED, That the Legislative Budget and Finance Committee
9conduct a study of specialty tier prescription drugs to
10determine the impact on access and patient care; and be it
11further

12RESOLVED, That the committee report its findings and
13recommendations to the Senate no later than <-January 30, 2014 
<-14July 15, 2014.