FEATURE
High-Cost Drugs
Continued from page 69
and stifle innovation at a time when we are just
about to see fruition in these investments is
counterproductive.”
However, Dr. Rajkumar disagreed that
these government agencies could not handle
issues of cost.
“We are entrusting the government to decide
which drugs to approve and which not to,” he
reasoned. “It is not a stretch to say that they be
able to set a target price based on what the drug
has to offer since they are giving the companies
a right to exclusivity for many years. This is what
most other developed countries do.”
First, the new Patients’ Access to Treatments Act (H.R. 1600) is designed to limit costsharing requirements for medications placed
in specialty tiers.7 Most people are familiar
with the pharmacy benefit tier system in place
for patients to receive drugs: Tier 1 is generic;
Tier 2 is preferred; and Tier 3 is non-preferred/
brand name. However, more and more payers
are placing expensive or complicated therapies
into newly instituted “specialty tiers,” according to Johanna Gray, MPA, vice president of
Cavarocchi, Ruscio, Dennis Associates, a government relations, public policy, and strategic
development firm that works with ASH.
“