Reps. Terri Sewell and Gus Bilirakis introduce legislation to increase access to oral prescription drugs

Terri Sewell

Congresswoman Terri Sewell (D-AL07) joined U.S. Representative Gus Bilirakis (R-Florida) in introducing H.R. 4011, the Timely Access to Clinical Treatment (TACT) Act. This bipartisan legislation would require patients to receive their oral drugs within an acceptable time frame.

“Undergoing treatment for a serious illness is difficult enough. No patient should also have to worry about delays in receiving potentially life-saving medication,” said Rep. Sewell. “The TACT Act is a simple, commonsense solution that would remove unnecessary roadblocks and empower doctors to get their patients the critical care that they need in a timely manner. I am proud to introduce this bill and urge my colleagues to support it.”

“This bill is about removing the red tape within our healthcare system and ensuring that patients have timely access to their medications,” said Rep. Bilirakis. “Doctors, not bureaucrats, best understand the needs of their patients and should be empowered with the tools needed to provide the best possible care—especially when time is of the essence.”

According to the sponsors, patients’ access to the appropriate medically necessary treatment within a reasonable time frame is increasingly challenged by our complex healthcare delivery system. This is especially true for oral drugs.

The sponsors claim that pharmacy benefit managers (PBMs), health insurance plan sponsors, and specialty and mail-order pharmacies are notorious for slowing down the process by which patients receive their oral drugs, even in cases where specialty practices can provide those drugs at the site of care via an in-house pharmacy or dispensing facility. In some cases, PBMs even disallow the medications prescribed. 

The TACT Act requires that patients be provided their oral drugs within an acceptable time frame of 72 hours, allowing for situations—such as acquiring financial support—that are understandable and reasonable.

The TACT Act will: 

· Require PBMs, plan sponsors, insurers, and contract pharmacies, including specialty and mail-order pharmacies, to ensure that patients are able to receive their prescription medication within 72 hours of having the prescription submitted to the patient’s pharmacy benefit plan provider in order to ensure that there is no undo delay in the initiation of the patient’s treatment;

· Allow patients who are not able to receive their prescription from a pharmacy benefit plan provider within 72 hours to seek pharmacy services and receive their prescription medication from any other duly-licensed entity that can fill the patient’s prescription and require that it be covered under the patient’s plan with full use of the patient’s applicable benefit(s);

· Require pharmacy benefit plan providers receiving the prescription to confirm within 24 hours to the patient’s prescriber receipt of the prescription and the ability to fill it within the 72-hour period; and

· Require that any prior authorization required by the pharmacy benefit plan provider take place in such a time that the 72-hour time limit is not exceeded.

Ted Okon is the Executive Director of the Community Oncology Alliance.

“The Timely Access to Clinical Treatment legislation is vital for patients with cancer and other serious diseases across the country,” said Director Okon. “We hear stories daily about patients not being able to receive their potentially life-saving cancer treatments because of needless delays by contract pharmacies. We applaud Congressman Bilirakis and Congresswoman Terri Sewell for leading this effort to empower patients to ensure they receive their medications in a timely manner.”

Terri Sewell is in her seventh term representing Alabama’s Seventh Congressional District.

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