A state legislator plans to introduce legislation that would prohibit health insurers from charging a co-payment of more than 20 percent for multiple sclerosis drugs that patients inject themselves.
The proposal by Assemblyman Paul A. Tokasz, D-Cheektowaga, follows criticism of the recent decision by Health Care Plan and Independent Health to increase co-payments significantly for self-injected drugs as of Jan. 1.
Tokasz described his proposal as a start, noting that it only pertains to multiple sclerosis.
Self-injected medications, some of them costing more than a $1,000 a month, also are used by cancer patients and by small children on synthetic growth hormone.
Multiple sclerosis, a chronic inflammatory disease of the central nervous system, causes weakness, loss of coordination and, in severe cases, paralysis.
In recent years, three drugs that slow the progression of the disease have come on the market: Betaseron, Copaxone and Avonex, which was pioneered by Dr. Lawrence D. Jacobs, a Buffalo neurologist.
Studies show higher rates of multiple sclerosis in a geographic band across the northern United States and southern Canada. In Western New York, the incidence of the disease is nearly twice the national average.
"Faced with these statistics, raising the cost of treating this disease is flat-out unjust and disproportionate," Tokasz said.
The proposed increases require approval by the state Insurance Department.
Officials of the health plans have said the increase reflects higher prescription costs. Health Care Plan officials also said they took on an unacceptable amount of financial risk when Community Blue and Independent Health raised co-payments, forcing patients who self-inject the medications into Health Care Plan.