WASHINGTON, Aug. 10, 2011 /PRNewswire-USNewswire/ -- In a just-released National Minority Quality Forum Issue Brief (Specialty Tiering: Unequal Treatment http://www.nmqf.org/IB3SpecialtyTiersFinal.pdf ), Gary Puckrein and Gretchen Wartman examine specialty tiering, which has become popular among insurers (public and private) as a benefit-management tool to limit their financial exposure by requiring beneficiaries to pay more for certain high-cost prescription drugs. The authors remind us that, the Institute of Medicine cautioned in 2003: "Aspects of health systems—such as the ways in which systems are organized and financed, and the availability of services—may exert different effects on patient care, particularly for racial and ethnic minorities" (Brian D. Smedley, Adrienne Y. Stith, and Alan R. Nelson, eds., Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care [Washington, DC: National Academies Press, 2003], p. 8). Specialty tiering exerts different effects by design. It chips away at the risk-pooling effects of insurance by shifting a significant percentage of the cost of expensive medical treatments to beneficiaries, possibly forcing the less affluent to choose between paying for basic living expenses or taking their medications. Cost shifting without means testing compromises access to quality care and increases the potential for disparate and poor health-care outcomes among minority populations, the financially less able, beneficiaries with cancer or other complex diseases that require expensive medical therapies, and those whose biologies may cause them to metabolize drugs differently.
"We believe that this issue brief is quite timely," explains Dr. Puckrein, who is president and chief executive officer of the National Minority Quality Forum. "The current economy not only calls for creati