Gearing Up!

I am looking forward to this year's Legislative Affairs Day, March 5th at the State Capitol. Close to 100 people from across Wisconsin will gather together against Multiple Sclerosis (MS). I think that every year we are even more effective than the last as more people travel to Madison to share stories and advocate together.

At our first Legislative Affairs Day, five years ago, we successfully secured the money to fund MS screenings for Wisconsin women through the Wisconsin Well Woman Program. The majority of people living with MS are women. This legislative accomplishment was made possible by Wisconsin volunteers who visited legislators and shared their stories about MS.

I look forward to talking to my Representative and State Senator this year about the problem with allowing "Tier 4" insurance drug co-pays to exist in Wisconsin. Tier 4 drugs include biological drugs scientifically proven to reduce the incidence of MS disease activity in people living with MS. My interferon drug, Interferon-B, now costs $2600 per month. Tier 4 co-pays are typically 25% or even 33% of a drugs costs.

For a person living with MS, who has Tier 4 drug co-pays in his/her insurance plan, s/he can have an $850 out-of-pocket expense -- that's like a mortgage on a modest home in many Wisconsin towns.How free is this person? Can't go shop for a different policy because no insurance company will sell him/her one. People who need this medicine to keep moving (and working and staying optimally productive) need it affordable or too many will decide to stop using it. And some will find themselves bound to a job, for only insurance that covers necessary healthcare services.

Tier 4 drug co-pays are a recent development in health insurance. Insurers are increasingly offering health insurance with Tier 4 drug co-pays as a way to "control costs" [for them]. Plans with Tier 4 drug co-pays cost less. Employers that provide employee insurance, looking for a way to "control [the] costs" might seek to save money [for themselves] and buy this insurance. Maybe your employer has already announced that your health insurance has changed?

Employers have an economic interest in buying health insurance that include a Tier 4 prescription drug plan. If you do not have a health insurance plan with Tier 4 prescription co-pays and you use a biological drug, you are lucky -- for now, but be aware you could be next!

I'm going to Legislative Affairs Day to advocate to end Tier 4 health plans in Wisconsin. We need to end Tier 4 -- there needs to be a cap on how much out-of-pocket any drug costs.