Montana to be First State to Change Health Insurance Price Structure for Specialty-Tier Drugs

Montana is changing the way specialty-tier prescription drugs are paid for. Right now, most prescription plans offer no co-pays for these types of drugs and patients must instead pay a percentage of the cost of the drugs themselves which can be exorbitant. Montana office of securities and insurance spokeswoman Jennifer McKee explains why the current system is “discriminatory.”

"These specialty drugs are generally used to treat a handful of common conditions: multiple sclerosis, cancer, hepatitis and HIV. It was our belief, and the insurance companies agreed with us, that just these people with these certain conditions had to come up-front with thousands of dollars, but other people with other conditions didn't have to. These people were being treated differently than other folks."

Montana is the first state to make this change and McKee says other states are paying attention.

"There has been discussion about trying to deal with the treatment of specialty-tier drugs across the country. We're getting a lot of attention from other states, wanting to know how we did this, and our insurance companies agreed to it. I think part of the reason why they agreed to it is that it's discriminatory, that's not right. No one wants discrimination, not even the insurance companies."

McKee says the change will take place next year and that insurance prices are not expected to rise.

Jennifer McKee: