Although any Virginian might be affected by high co-insurance, those patients most affected by adverse tiering include Virginians living with chronic illnesses such as rheumatoid arthritis, hemophilia, multiple sclerosis and those with life-threatening conditions such as HIV, breast cancer, colorectal cancer and leukemia. 

Many patients with these conditions must take multiple medications to improve the quality and duration of their lives, and the drugs necessary to treat these conditions are typically newer, produced in lesser quantities than other drugs, and not available as less expensive generics.