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A05371 Summary:

BILL NO    A05371 

SAME AS    No same as 

SPONSOR    Lifton (MS)

COSPNSR    Jaffee, Ortiz, Rivera, Gunther, Peoples-Stokes, Galef, O'Donnell

MLTSPNSR   Clark, Lupardo, Markey

Amd SS3216, 3221 & 4303, Ins L

Requires prescription coverage for the treatment of shingles.
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A05371 Memo:

BILL NUMBER:A5371

TITLE OF BILL:

An act to amend the insurance law, in relation to prescription
coverage for shingles

PURPOSE OR GENERAL IDEA OF BILL:

This bill would ensure that the prescription drug for the treatment of
shingles be covered by every insurance policy, including hospitals and
health services that provide coverage for prescription drugs.

SUMMARY OF SPECIFIC PROVISIONS:

S 1 would amend subsection (i) of section 3216 of the insurance law;
2 would amend subsection (1) of section 3221 of the insurance law; S 3
would amend section 4303 of the insurance law: these amendments shall
provide prescription coverage for Zostavax under every policy and
contract issued by a hospital or health services corporation, which
provides coverage for prescription drugs.

JUSTIFICATION:

Shingles (herpes zoster), is a viral infection of the nerve root,
which causes severe pain and a blistering-rash that spreads on one
side of the body, most often found in older adults due to weakened
immunity that comes with advancing age. Shingles is caused by the
varicella-zoster virus - the same virus that causes chickenpox - that
remains in a dormant state after someone has had chickenpox, but which
can reactivate, multiply and damage sensory nerve cells. This very
painful disease can lead to serious and long-lasting complications,
such as postherpetic neuralgia (PHN), that can last anywhere from 30
days to months or even years. The pain is usually severe enough for a
doctor to prescribe painkillers and can degrade the quality of life.
There are approximately 50 million Americans over age 60 - 95% of whom
had chickenpox as children - making them vulnerable to shingles. It is
estimated that 1 million people develop shingles in the United States
each year.

Zostavax, the first vaccine to protect adults against shingles, has
been shown to reduce the incidence of shingles by fifty-one per cent
and the severity and complications of shingles were dramatically
reduced in those who got the disease. It has also been shown to reduce
the incidence of postherpetic neuralgia (PHN) by two-thirds.  The
safety and efficacy of Zostavax for older adults has been proven,
according to a study published in THE NEW ENGLAND JOURNAL OF MEDICINE,
June 2005. Zostavax was approved by the Federal Food and Drug
Administration in May 2006, and in October 2006, the Center of Disease
Control's (CDC) Advisory Committee on Immunization Practices (ACIP)
voted to recommend that Zostavax be given to all adults age 60 and
over, including those who have had a previous episode of shingles. The
Secretary of the United States Department of Veterans' Affairs, R.
James Nicholson, recently announced the immediate availability of the
vaccine to veterans at Veterans' Affairs medical facilities who are
recommended for the treatment.


As people live longer and the proportion of older people in our
population increases, it is highly likely that the prevalence of
shingles will increase. It is estimated that fifty-percent of those
who live to age 85 will get the disease. Lack of insurance coverage
could impede lower-income people from getting the vaccine. This bill
will provide much-needed coverage for prescription drugs for the
treatment of shingles, under the prescription of a health care
provider or by a hospital or a health services corporation which
provides coverage for prescription drugs.

PRIOR LEGISLATIVE HISTORY:

2007-2008: A9469; referred to insurance
2009-2010: A4082; referred to insurance
2011-2012: A3901; referred to insurance
2013-2014: A887; referred to insurance

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:

This act shall take effect on the sixtieth day after it shall have
become a law.
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