NBC in Connecticut ran a really great story on the burden people with chronic illnesses face as insurers expand the use of specialty tiers. Specialty tiers are used by insurers to take a category of drugs -- usually, drugs that are expensive -- and apply a percentage coinsurance instead of a fixed copay. So, for example, the woman profiled in this story would have had to spend over $11,000 per year for her medication. Due to the expense, she has had to stop taking the drug and her symptoms have worsened.
This is a tough one. The cost of many drugs is through the roof. However, are we prepared as a society to allow insurers to make them completely unaffordable? If not, who bears the cost -- insurers or society as a whole? And if so, what about the cost of treating illnesses when drugs that would keep those illnesses in remission are out of reach of a lot of patients, so their health care costs end up skyrocketing when their condition spirals out of control?
Unfortunately, there appear not to be ready answers to those questions on the public policy level. We'll keep at it, though. Jennifer