Full Text of HR1171 96th General Assembly
HR1171 96TH GENERAL ASSEMBLY
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| HOUSE RESOLUTION
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| WHEREAS, Psoriasis is the most prevalent autoimmune | 3 |
| disease in the country; and
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| WHEREAS, Psoriasis is a noncontagious, chronic, | 5 |
| inflammatory, painful, and often disfiguring and disabling | 6 |
| autoimmune disease for which there is no cure; and
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| WHEREAS, Up to 30% of people with psoriasis also develop | 8 |
| psoriatic arthritis, which causes pain, swelling, and | 9 |
| stiffness around the joints; and
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| WHEREAS, Of serious concern is the mounting evidence that | 11 |
| psoriasis is not just a disease of the skin and joints, but is | 12 |
| a systemic disease that is connected with an elevated risk for | 13 |
| a range of other serious, chronic, and life-threatening | 14 |
| conditions, including cardiovascular disease, diabetes, | 15 |
| hypertension, and stroke; and
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| WHEREAS, Psoriasis affects approximately 325,000 people in | 17 |
| Illinois; and
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| WHEREAS, Phototherapy is treatment exposing the skin to an | 19 |
| artificial ultraviolet light source for a set length of time on | 20 |
| a regular schedule; and
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| WHEREAS, Phototherapy is a safe, effective, and commonly | 2 |
| prescribed first-line treatment for psoriasis; and
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| WHEREAS, Phototherapy is also a critical treatment option | 4 |
| for psoriasis patients who are prevented from taking other | 5 |
| medications because of conditions such as pregnancy, | 6 |
| infection, or malignancy; and
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| WHEREAS, Surveys of psoriasis patients indicate that | 8 |
| approximately 18% use phototherapy to treat their psoriasis, or | 9 |
| about 58,500 people in Illinois; and
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| WHEREAS, An inefficient insurance payment structure | 11 |
| relying upon excessively high copayments interferes with the | 12 |
| use of this relatively inexpensive treatment and creates a | 13 |
| barrier to accessing care for patients who need this safe, | 14 |
| effective, and economical option to treat their disease and | 15 |
| live a normal life; and
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| WHEREAS, The burden of health care costs continues to shift | 17 |
| to the consumer, and many patients now face copayments as high | 18 |
| as $50 for a single phototherapy visit; and
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| WHEREAS, A typical start-up regimen for the most common | 20 |
| type of phototherapy is 3 visits per week for 8 to 12 weeks; |
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| long-term maintenance regimens are usually required; and
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| WHEREAS, Out-of-pocket costs quickly soar and can be as | 3 |
| much as $600 for one month of treatment; and
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| WHEREAS, The overall cost to the health system of | 5 |
| phototherapy treatment is relatively economical; and
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| WHEREAS, Other treatments for psoriasis, while important | 7 |
| options for some patients, can have serious side effects and | 8 |
| pose substantially overall higher costs to the health care | 9 |
| system; and
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| WHEREAS, High copayments are keeping patients from using | 11 |
| phototherapy and, as a result, they either opt out of treatment | 12 |
| entirely or prematurely move to more expensive and sometimes | 13 |
| riskier therapies; and
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| WHEREAS, Systemic treatments may have a much lower monthly | 15 |
| copayment under certain prescription plans than phototherapy, | 16 |
| discouraging patients from trying phototherapy first; and
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| WHEREAS, This unwise and inefficient cost-shifting policy | 18 |
| can deter patients from pursuing any treatment at all, | 19 |
| resulting in long-term costs as these patients worsen without | 20 |
| treatment; this may also result in patients moving on to |
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| treatments with lower copays to the patient but higher overall | 2 |
| costs to the health care system; and
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| WHEREAS, Organizations, including the National Psoriasis | 4 |
| Foundation, the Dermatology Nurses' Association, the | 5 |
| Photomedicine Society, and the American Academy of Dermatology | 6 |
| Association call for a fair solution in order to ensure access | 7 |
| to safe, less expensive treatments; and
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| WHEREAS, Ninety percent of health care providers in a | 9 |
| national survey agreed that the substantial copay associated | 10 |
| with phototherapy limits a patient's ability to undergo this | 11 |
| form of treatment; and
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| WHEREAS, Health care providers continue to express serious | 13 |
| concern about the number of patients who discontinue | 14 |
| phototherapy due to the cost, estimating that cost is the most | 15 |
| common reason for stopping this treatment; and
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| WHEREAS, Data is not available to establish the number of | 17 |
| patients who definitively move prematurely or unnecessarily to | 18 |
| more expensive systemic medications due to high phototherapy | 19 |
| copays or do not receive treatment at all for their disease; | 20 |
| and
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| WHEREAS, Uniform information on the costs associated with |
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| treatment of psoriasis in the State of Illinois and potential | 2 |
| cost savings to both insurance carriers and patients that may | 3 |
| be realized from the elimination or reduction of phototherapy | 4 |
| copays is needed to determine a fair and cost-effective | 5 |
| solution for patients, providers, and insurers; therefore, be | 6 |
| it
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| RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE | 8 |
| NINETY-SIXTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that we | 9 |
| urge the Department of Insurance, in consultation with | 10 |
| insurance companies, support groups and medical practitioners | 11 |
| for persons with psoriasis, the Department of Central | 12 |
| Management Services, and the Department of Healthcare and | 13 |
| Family Services to undertake a study on the costs and systemic | 14 |
| inefficiencies associated with phototherapy treatment and the | 15 |
| impact of out-of-pocket costs on the ability of psoriasis | 16 |
| patients to access treatment; and be it further
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| RESOLVED, That the study may include analyses of costs and | 18 |
| the impact to patients who access phototherapy treatments for | 19 |
| other diseases in addition to psoriasis; and be it further
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| RESOLVED, That the Department of Insurance shall examine to | 21 |
| the extent possible (i) the number of psoriasis patients in | 22 |
| Illinois receiving phototherapy; (ii) the costs associated | 23 |
| with phototherapy, including cost to the patient, cost to the |
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| health care provider, and rates of reimbursement by insurance | 2 |
| carriers; (iii) the number of psoriasis patients who terminate | 3 |
| phototherapy treatment; (iv) the reasons for termination of | 4 |
| phototherapy treatment; (v) the treatment options used by | 5 |
| patients after termination of phototherapy treatment; and (vi) | 6 |
| the costs associated with treatments used after termination of | 7 |
| phototherapy treatment; and be it further | 8 |
| RESOLVED, That suitable copies of this be delivered to the | 9 |
| Governor, the Director of Insurance, the Director of Central | 10 |
| Management Services, the Director of Healthcare and Family | 11 |
| Services, and the Attorney General.
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