HR1171 96TH GENERAL ASSEMBLY

HR1171 LRB096 22085 RPM 40579 r

HOUSE RESOLUTION

WHEREAS, Psoriasis is the most prevalent autoimmune disease in the country; and

WHEREAS, Psoriasis is a noncontagious, chronic, inflammatory, painful, and often disfiguring and disabling autoimmune disease for which there is no cure; and

WHEREAS, Up to 30% of people with psoriasis also develop psoriatic arthritis, which causes pain, swelling, and stiffness around the joints; and

WHEREAS, Of serious concern is the mounting evidence that psoriasis is not just a disease of the skin and joints, but is a systemic disease that is connected with an elevated risk for a range of other serious, chronic, and life-threatening conditions, including cardiovascular disease, diabetes, hypertension, and stroke; and

WHEREAS, Psoriasis affects approximately 325,000 people in Illinois; and

WHEREAS, Phototherapy is treatment exposing the skin to an artificial ultraviolet light source for a set length of time on a regular schedule; and

WHEREAS, Phototherapy is a safe, effective, and commonly prescribed first-line treatment for psoriasis; and

WHEREAS, Phototherapy is also a critical treatment option for psoriasis patients who are prevented from taking other medications because of conditions such as pregnancy, infection, or malignancy; and

WHEREAS, Surveys of psoriasis patients indicate that approximately 18% use phototherapy to treat their psoriasis, or about 58,500 people in Illinois; and

WHEREAS, An inefficient insurance payment structure relying upon excessively high copayments interferes with the use of this relatively inexpensive treatment and creates a barrier to accessing care for patients who need this safe, effective, and economical option to treat their disease and live a normal life; and

WHEREAS, The burden of health care costs continues to shift to the consumer, and many patients now face copayments as high as $50 for a single phototherapy visit; and

WHEREAS, A typical start-up regimen for the most common type of phototherapy is 3 visits per week for 8 to 12 weeks; long-term maintenance regimens are usually required; and

WHEREAS, Out-of-pocket costs quickly soar and can be as much as $600 for one month of treatment; and

WHEREAS, The overall cost to the health system of phototherapy treatment is relatively economical; and

WHEREAS, Other treatments for psoriasis, while important options for some patients, can have serious side effects and pose substantially overall higher costs to the health care system; and

WHEREAS, High copayments are keeping patients from using phototherapy and, as a result, they either opt out of treatment entirely or prematurely move to more expensive and sometimes riskier therapies; and

WHEREAS, Systemic treatments may have a much lower monthly copayment under certain prescription plans than phototherapy, discouraging patients from trying phototherapy first; and

WHEREAS, This unwise and inefficient cost-shifting policy can deter patients from pursuing any treatment at all, resulting in long-term costs as these patients worsen without treatment; this may also result in patients moving on to treatments with lower copays to the patient but higher overall costs to the health care system; and

WHEREAS, Organizations, including the National Psoriasis Foundation, the Dermatology Nurses' Association, the Photomedicine Society, and the American Academy of Dermatology Association call for a fair solution in order to ensure access to safe, less expensive treatments; and

WHEREAS, Ninety percent of health care providers in a national survey agreed that the substantial copay associated with phototherapy limits a patient's ability to undergo this form of treatment; and

WHEREAS, Health care providers continue to express serious concern about the number of patients who discontinue phototherapy due to the cost, estimating that cost is the most common reason for stopping this treatment; and

WHEREAS, Data is not available to establish the number of patients who definitively move prematurely or unnecessarily to more expensive systemic medications due to high phototherapy copays or do not receive treatment at all for their disease; and

WHEREAS, Uniform information on the costs associated with treatment of psoriasis in the State of Illinois and potential cost savings to both insurance carriers and patients that may be realized from the elimination or reduction of phototherapy copays is needed to determine a fair and cost-effective solution for patients, providers, and insurers; therefore, be it

RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE NINETY-SIXTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we urge the Department of Insurance, in consultation with insurance companies, support groups and medical practitioners for persons with psoriasis, the Department of Central Management Services, and the Department of Healthcare and Family Services to undertake a study on the costs and systemic inefficiencies associated with phototherapy treatment and the impact of out-of-pocket costs on the ability of psoriasis patients to access treatment; and be it further

RESOLVED, That the study may include analyses of costs and the impact to patients who access phototherapy treatments for other diseases in addition to psoriasis; and be it further

RESOLVED, That the Department of Insurance shall examine to the extent possible (i) the number of psoriasis patients in Illinois receiving phototherapy; (ii) the costs associated with phototherapy, including cost to the patient, cost to the health care provider, and rates of reimbursement by insurance carriers; (iii) the number of psoriasis patients who terminate phototherapy treatment; (iv) the reasons for termination of phototherapy treatment; (v) the treatment options used by patients after termination of phototherapy treatment; and (vi) the costs associated with treatments used after termination of phototherapy treatment; and be it further

RESOLVED, That suitable copies of this be delivered to the Governor, the Director of Insurance, the Director of Central Management Services, the Director of Healthcare and Family Services, and the Attorney General.