And Community Health thank you very much. Thank you so next, i want to call up james and matt from the San Francisco aids foundation and. Good afternoon supervisors. Thank you first i want to thank you for bringing up this important discussion and opportunity im james the Vice President of Public Affairs at San Francisco aids foundation and i want to start by saying i stand before everyone with tremendous help the reason; right why the progress is one hundred percent when you think about it today Community Cross the United States for the very first time are designing and implementing plans to eliminate the transition of aided even a few years ago would have been unthinkable this is progress we cant take for granted now more than ever we have to identify threats to this as we work to make San Francisco the first hiv transition were here today to address one of the threats San Francisco aids foundation is concerned does the description between the lack of transparency in the health plans
Because of the lack of understanding of the speciality drugs i put speciality drug in quotations this may be based on costs the important point i want to make awhile making progress in california if we enact all the things in our tool dheft well not make a difference until the pharmaceutical Companies Come to the table theyre not there yet and extremely highpriced drugs make it difficult for Insurance Companies to make them affordable and the reason for that the plans are negotiators would the companies about the cost of those drugs so they need to have a type of mechanism like a tiering mechanism in order to bring the companies to the table to lower their prices this is unfortunate because the consumer losses so when we had extreme expensive drugs there shs cost sharing because of the necessity to negotiate and that at least a lot of assess and discrimination against people the first effort i want to talk about the cover california that is a groundbreaking effort and they brought toge
To have a dedicated Pharmacy Service line that advocates and consumers can call to answer their questions and in addition colorado lien said standardized the tier definition so we know what drugs are in what tier i want to point out not all plans use the tier blue shield as a 1,200 threshold im not certain but it is definitely higher in california recommendations also is that if there are 3 or more Treatment Options for treatment at least one drug in that drug category has to be an tier 13 and this is specifically 5i78d and rheumatoid 5th reiterates and lupus for us it didnt go far enough only one drug is there people need different drugs to treat hiv and aids the board is asking to access the implementation of caps on the speciality tier the issue is that when Insurance Companies putting put caps on the speciality tier cost sharing that means a substantial increases for drugs so it is important for california to keep the formulas reasonable so i want to see the actuary process before
Reductions with the network which helped individuals to reduce the costs this hearing is timely in that this last week im helping a client for 14 months his individual copay was 35 a month until recently changed under the speciality tier which brought him up to 500 a month pharmacy bill this was factoring in the fact you have to pay for individual to the doctor as well as the lab during the pricing and gain access to medication through programs you such Medication Assistance Program and a copay card and assess network we reduced those costs for the individual is looking at 20,250 a month this is well outside of his financial bracket he came to us seeking proving lax assess because of the speciality tearing of the medication we provided him a pass and are actively helping him to continue for his access to life saving services. I want to acknowledge katherine dodge do you want to Say Something about this issue with our familiarity. Thank you katherine dodi want to highlight because we sp
Look to the state of california to clarify those although the government has said they last sector as colleen said did say we may have discrimination of all drugs placed on the highest tiers but they kind of not mitigated it but they added to this in a way that wasnt helpful in saying the plans could also use another factor to see why the drugs are tiered at the highest level not showing a factor that is discriminatory so what i was going to do into into depth at the state level to make changes i pointed out i started with this as a presentation because of the lack of understanding of the speciality drugs i put speciality drug in quotations this may be based on costs the important point i want to make awhile making progress in california if we enact all the things in our tool dheft well not make a difference until the pharmaceutical Companies Come to the table theyre not there yet and extremely highpriced drugs make it difficult for Insurance Companies to make them affordable and the r