With the recent passing of the Right to Try Act, which gives terminally ill patients access to experimental treatments that have not yet been approved by the FDA, it may be important to understand if and how this impacts the benefits you currently offer your employees. The first thing to know is that Right to Try does not mandate or require insurance coverage of experimental drugs, nor of their potential side effects. Another thing you may not know is that while experimental drugs were previously available under Right to Try legislation in 38 states, only one patient has taken advantage of the benefit.

According to the Self Insurance Institute of America, it is important for those with self-funded plans to review how the plan document treats access and payment of experimental drugs. It is also important to determine how your plan currently covers experimental drug treatments and side effects under the FDA Expanded Access program. Finally, we recommend having a conversation with your TPA to identify not only any potential compliance issues that may exist within your current plan, but how your company would like to treat Right to Try related expenses going forward.