By Mark Hobraczk, JD, MPA


District of Columbia

Committee approves legislation capping specialty tier drug cost-sharing

The subcommittee on Consumer Affairs for the Committee of the Whole unanimously passed legislation last month that would limit copayment and coinsurance obligations for specialty tier drugs to no more than $150 for a 30-day supply or $300 for a 90-day supply. Both limits will be annually adjusted based on the Consumer Price Index for the region that is set by the U.S. Department of Labor.

The Specialty Drug Copayment Limitation Act of 2015 (B21-0032) was initially introduced in the Committee on Business, Consumer, and Regulatory Affairs in January 2015, which held an October 2015 public hearing at which numerous consumer groups including PSI testified in support (see Specialty Tier Reform Update for Week of November 30, 2015). It was re-referred to the subcommittee last September, which added the limit on a 90-day supply based on comments received at the hearing indicating that 90- day prescriptions are “common” and “usually less than simply three times the 30-day cost.”

The subcommittee also delayed the effective date by one year until January 1, 2018 to provide ample time for the measure to be debated by the full Council of the District of Columbia.

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