Rhode Island General Assembly passes legislation to expand health insurance coverage for off-label use of prescription medications
July 25, 2016
Good news for Rhode Islanders living with MS! The Rhode Island General Assembly passed legislation that expands health insurance coverage to include off-label use of prescription medications for the treatment of disabling or life-threatening chronic diseases. The House bill (H.7512) sponsored by Rep. K. Joseph Shekarchi (D- District 23, Warwick) and the Senate bill (S.2499) sponsored by Sen. William A. Walaska (D- District 30, Warwick) became law after being signed by Governor Gina Raimondo on June 17, 2016.
The legislation requires health insurers to provide coverage for off-label use of FDA-approved drugs used for the treatment of disabling, chronic, or life-threatening diseases. Prescribing off-label medications is common practice within the medical community. When a doctor prescribes a medication “off label,” it means that the medication is being used to treat a symptom or disease which has not received FDA approval, not that the medication itself has not been reviewed by the FDA. This legislation expands the kind of comprehensive coverage previously only available for cancer treatments.
The advocacy staff and Government Relations Advisory Committee at the National MS Society, Greater New England Chapter worked closely with Joseph Guarnaccia, M.D. to advocate strongly for this legislation. Dr. Guarnaccia is the medical director of the MS Center at Care New England in East Greenwich, RI and specializes in the treatment of multiple sclerosis. He spearheaded this effort and worked closely with the RI Attorney General’s office and with the prime bill sponsors to advance this important legislation. After the bill was signed into law by the Governor, Dr. Guarnaccia stated, “The passage of this bill is a victory as the changes in legislation open new possibilities for people with multiple sclerosis as well as others living with disabling illnesses…we need to make sure that Rhode Island residents know that off-label medications may now be a viable option for their treatments, especially if on-label medications have not worked for them.”
Meredith Sheehan, Community Program Manager for the National MS Society in Rhode Island added that, “There are over 2,000 people in Rhode Island who are living with multiple sclerosis. Due to the significant variability in the MS population, people with MS and their treating clinicians require full access to a range of treatment options. Many medications used to treat MS symptoms are prescribed off-label because they have never been approved specifically for use in MS. A doctor will prescribe a medication that he or she feels will be beneficial and safe, even if it is not specifically approved for that use.”
According to the Rhode Island Attorney General Peter Kilmartin, one in five prescriptions in Rhode Island are written for off-label use for those suffering from disabling or life-threatening chronic diseases. This expansion of coverage is critical to people with MS who rely on off-label medications to slow or prevent disease progression and to ease the symptoms of MS.
About the Greater New England Chapter of the National Multiple Sclerosis (MS) Society
The National MS Society mobilizes people and resources to drive research for a cure and to address the challenges of everyone affected by MS. The Society’s Greater New England Chapter serves 21,000 individuals and families affected by MS in Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. Early and ongoing treatment with an FDA-approved therapy can make a difference for people with multiple sclerosis. Learn about your options by talking to your health care professional and by contacting the National MS Society at www.MSnewengland.org, or 1 800 FIGHT MS (344 4867).
About Multiple Sclerosis
Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.