Helping Hoosiers get the care they need
According to the American Medical Association, health care spending in the United States increased by 4.6% in 2019 to $3.8 trillion, or $11,582 per person. One of the largest areas of rising health care costs is in specialty drugs like infusion therapies for cancer patients, which only account for 2% of all prescriptions but almost half of all medication spending.
A new law I supported created a working group to report on best practices in providing specialty drugs and found that, while providers have shifted to “white bagging” to help drive prices down, this can lead to delays in drug shipments and patient care.
White bagging is when an insurance company requires a health care provider to obtain specialty drugs for their patients from a third-party specialty pharmacy. This happens most often with patients diagnosed with arthritis, cancer and hemophilia who require a long-term treatment plan. Because these treatments have limited or exclusive distribution, and require dosing adjustments, clinical monitoring and expanded services, the costs for these specialty drugs can be quite high. Health care providers work with these specialty pharmacies, which are sometimes owned by or affiliated with the insurance company, to help lower these costs.
As a pharmacist and vice chair of the House Public Health Committee, I am concerned about white bagging delaying patient care for Hoosiers with severe medical conditions. For example, an oncologist may have to adjust treatment based on an evaluation before a cancer patient’s scheduled infusion. These adjustments could lead to delays while waiting for authorization from an insurance company for new medications or treatments. Unfortunately, we have already seen Hoosiers die while waiting for life-saving care.
A few states have already passed legislation regulating this practice, including Louisiana, which passed a law in June banning health insurance companies from requiring drugs to be white bagged.
Editor’s note: State Rep. Steve Davisson, R-Salem, submitted this column prior to his death Sunday, Sept. 19.