By Darren Smith, Weekend Contributor
In a rarely seen demonstration of unity in an otherwise strongly divided political environment, the Washington State Legislature unanimously voted to allow cancer patients to donate expensive medications to other patients who are underinsured. As expected, the governor signed the measure into law.
It is a welcome first step in allowing access to drugs otherwise unaffordable and potentially economically bankrupting to patients and their families. In addition to its obvious health benefit, the law surely will provide reassurance and a small amount of respite during stressful times for those in need.
This laudable and heralding law originated from the efforts of cancer patient Jonathan Van Keulen and his wife Becky. Jonathan was diagnosed with a rare form of bone cancer and in the spring of last year the couple founded the non-profit “Cancer Can’t” to provide services and support for similarly afflicted individuals and their loved ones. Additionally, and with the assistance of State Representative Kevin Parker of Spokane, the “Cancer Can’t Charitable Pharmacy Act” came to fruition.
Unfortunately, on April 4th, Jonathan succumbed to his illness.
Despite the loss of his life and those facing his spouse and two sons, he brought forth a legacy through legislation that undoubtedly will benefit many more in years to come.
Engrossed Substitute House Bill 2458 (2015-16), amends Chapter 69.70 of the Revised Code of Washington (RCW). Pertinent amendments are discussed here.
(2) The person to whom a prescription drug was prescribed, or the3person’s representative, may donate prescription drugs under subsection (1) of this section if, as determined by the professional judgment of a pharmacist, the prescription drugs were stored under required temperature conditions using the prescription drugs’ time temperature indicator information and the person, or the person’s representative, has completed and signed a donor form, adopted by the department, to release the prescription drug for distribution under this chapter and certifying that the donated prescription drug has never been opened, used, adulterated, or misbranded.
Sec. 3. RCW 69.70.040 and 2013 c 260 s 4 are each amended to read as follows:
Pharmacies, pharmacists, and prescribing practitioners that elect to dispense donated prescription drugs and supplies under this chapter shall give priority to individuals who are uninsured (( and at or below two hundred percent of the federal poverty level)). If an uninsured ((and low-income)) individual has not been identified as in need of available prescription drugs and supplies, those prescription drugs and supplies may be dispensed to other individuals expressing need.
Sec. 4. RCW 69.70.050 and 2013 c 260 s 5 are each amended to read as follows:
(1) Prescription drugs or supplies may be accepted and dispensed under this chapter if all of the following conditions are met:
(a) The prescription drug is in:
(i) Its original sealed and tamper evident packaging; or
(ii) An opened package if it contains single unit doses that remain intact;(b) The prescription drug bears an expiration date that is more than six months after the date the prescription drug was donated;
(c) The prescription drug or supplies are inspected before the prescription drug or supplies are dispensed by a pharmacist employed by or under contract with the pharmacy, and the pharmacist determines that the prescription drug or supplies are not adulterated or misbranded;
(5) A prescription drug that can only be dispensed to a patient registered with the manufacturer of that drug, in accordance with the requirements established by the federal food and drug administration, may not be ((accepted or)) distributed under the program, unless the patient receiving the prescription drug is registered with the manufacturer at the time the drug is dispensed and the amount dispensed does not exceed the duration of the registration period.
Your author has some concerns about the requirement of a patient registering with a drug manufacturer as this can be made to be a bureaucratic process where the company might be reluctant to lose the sale of these drugs to a new patient. Experimental drugs surely might be excepted. A situation could develop where the manufacturer refuses to register the patient who in turn must go back to square one in attempting to find funding for their medications.
Despite these concerns the law surely is welcoming, for more than just these cancer patients but it offers cost savings to an already overburdened health care system.
The law is effective in 2017.
By Darren Smith
Sources:
The Columbia Basin Herald
Washington State Legislature
The views expressed in this posting are the author’s alone and not those of the blog, the host, or other weekend bloggers. As an open forum, weekend bloggers post independently without pre-approval or review. Content and any displays or art are solely their decision and responsibility.
Japan and Norway are not lying. You miss my point. Different countries define a “live birth” differently. This is a common problem in statistical analysis across countries. We are just comparing apples to oranges, and it wrenches the numbers. Welcome to statistics.
You can’t inject emotion into what is essentially a math problem. And please don’t ignore that many doctors won’t accept Obamacare individual policies. You have to do better than just “feeling good” about a vote. You have a responsibility to understand the consequences of your actions, and how it affects others. If your vote contrived to the financial calamity that befell those unsubsidized on Obamacare individual polices, then own it. Would you be willing to take a 30% pay cut, like doctors had to take?
In this case, there are a lot of people learning that doctors won’t accept their Obamacare individual policies. Aside from that, it is not disputed that Obamacare now combines what is essentially Cadillac premiums with Catastrophic style deductibles, restricted doctor networks, tightened drug formularies, the complete loss of off-formulary benefits, and anything you have to pay out of pocket for off formulary does not count towards your max caps. It is also not disputed that Obama deliberately lied to the American people about keeping their health insurance and their doctor, and saving $2500 annually.
If you think that’s “helping people”, then you need to get your priorities in order. A shiny new insurance card does not quality healthcare make. It’s just a piece of paper.
Yes, I guess it is always the fault of someone else.
Now it is lying Norway and Japan making our dead babies look bad. Just like it is the fault of the stoopid insurance company that cancelled an insurance policy for non-payment. Just as it is the fault of the stoopid government website that now covers 15 million more Americans with healthcare access.
HRH – well, Japan and Norway ignore those dead babies to make their numbers look better…
Remember that when you hear about how awful our healthcare is as an excuse to give our government, which can’t even design a website, more control.
Karen is absolutely right! As soon as we get smart and ignore all those dead babies and the nonsense American ills that are killing them, we’ll be NUMBER 1!!!!
isaac:
You may not be aware of how those rankings were determined. There was actually a scandal in the WHO about the ranking distribution. There were many cases of comparing apples to oranges. “Infant mortality” is defined differently across countries. Infants who were not viable and who die shortly after birth are counted as infant mortality stats in the US, but not in many other countries, like Japan, Sweden, Norway, Ireland, the Netherlands, and France, skewing the results. In some cases, the US infant mortality is skewed by 40%. We also go above and beyond many other countries in our efforts to save babies with poor prognosis. Instead of having a chance in our NICU, such infants would die at birth and not be counted in infant mortality rates in other countries. Further complicating our figures on infant mortality are cultural issues. We have higher rates of teen pregnancies than some other countries, and such babies have a higher risk of being born with Fetal Alcohol Syndrome, drug exposure, low birth weight, and in general poor prenatal care because the mom was in complete denial for 9 months. The skewed infant mortality rate also affect Life Expectancy rates, which are also calculated using those figures.
Our American diet is also utter crap compared to countries like Japan and France, and it’s linked to many health problems.
There are many other factors that affected our rankings and artificially skewed the results. That can happen when each country has its own way of collecting data.
I love the general idea of this program, and have several questions:
1. “An opened package if it contains single unit doses that remain intact.” Does this mean a half empty bottle of pills may be donated?
2. Registering with the drug manufacturer does not appear to provide a benefit, and the requirement should be removed.
3. Does the law absolute the pharmacist and donor of liability? Having helped care for several people who had cancer, I have seen patients get exhausted, really sick, and have brain fog during the entire horrid ordeal. There is some level of risk in donating medication. What if they empty out pill boxes into the wrong container? What if they forgot that they left it in a hot car a couple of days? Coughed on it or dropped the pills on the floor while they struggled with opening the darn cap? The reason why pharmacies will not accept returns of medications that have left the premises is the risk of liability. It also puts a lot of pressure on the pharmacist to properly identify pills based on size, shape, and imprint. Because I assume they are not going to run an assay on it.
4. Do the pharmacists get paid for their review? Do they require a rider on their insurance? If so, does the program cover their cost?
I think this is an excellent idea. Cancer treatment is prohibitively expensive, especially for those without insurance. Even those with insurance, thanks to Obamacare, are faced with enormous deductibles and premiums now, at a time when cancer patients typically are unable to work. Another tragic consequence of the ABA is that insurers tightened networks in order to try to rein in the spiraling costs caused by the act. That means that in the good old days of a few years ago, people’s insurance paid for them to see whatever doctor specialized in their cancer. No longer. If you’re not lucky enough to have your specialist in the newly uber tightened network, you’re screwed. To make everyone equal, they brought down the quality of individual policies so that they are now all equally awful. I just was at the doctor’s office, where they were explaining to a patient that they did not accept his individual Obamacare policy because they could not afford the pay cut. All they accept now are employer policies, and this is quite common.
Paul – I think that’s a great idea, to expand the policy to all medications that are life saving. I assume there is some considerable cost in administering the program and paying the pharmacists, so I wouldn’t want it applicable to every prescription. But for those crucial for health, it’s a wonderful, unifying idea.
The hockey playoff ball bust is just that, good natured ball busting. I don’t think that French Canadian, pretty boy, vapid, nepotism, being elected PM has anything to do w/ ALL the Canadian NHL team stinking up the league. Now, the last time no Canadian NHL team made the playoffs his stupid, old man was PM. But, I’m certain this is just a coincidence. Liberals have no sense of humor.
I wish they would do it for all drugs.
So sayeth the man who politicized the hockey playoffs.
(see note at 11:15)
I read people for a living. It can be difficult in this forum. But, over time, patterns evolve. This is a positive post about something GOOD that happened. The people that hate the US can’t even acknowledge the positive and simply bash the greatest country in the world. Anger consumes some people. Maybe they need some unused Prozac.
Great post, Darren.
Poor pharma cartel, lost profits.
Commentary on the intrusiveness of laws when we hail the legislature for “allowing” this basic act of decency.
We have reached the German stage – “What is not permitted, is forbidden.”.
There are reasons why the US ranks 37th in the world, in health care. There are reasons why the US ranks 98th in the world, in efficiency vis a vis money in and health care dispensed. Moves such as this are applaudable. However, they are minuscule when compared to the reforms that have been made in other more advanced health care systems. As long as health care is a business, there will be those who cannot afford it. The pinnacle of US health care is there only if you can afford it. Otherwise, the oligarchy, we so passionately call the world’s first and foremost democracy, tosses a few crumbs from time to time. Before the French Revolution, the oligarchs made sure the people had plenty of cheap wine and tobacco. Plenty of cheap big screens, cheap gas, and Ding Dongs….sound familiar?
On behalf of patients, eliminate patents.
Drop the i before e except after c.
It’s a good start. Maybe one day our government, of the people and for the people, will start negotiating drug prices like the rest of the civilized world. Meanwhile, this is a good thing.
Good idea.
Very little downside.
Kindness rarely makes it into law.
whoever came up with this idea should be supported by the government and have it promoted. also i guess there has to be a limit on much the wealthy can purchase so that one doesn’t buy in bulk and have them expired before they used.
Be careful around drugs.
I don’t want to appear ungrateful for small favors but this law as helpful as it may be doesn get to the root of the problem of pharmaceutical price gouging. American taxpayers pay to do the basic research and they pay for the R&D of these drugs and then we pay obscenely higher prices than anyone in the world it is a travesty.
What a wonderful idea! I hope 49 more states see the logic in this. What about other meds? If you have pills you no longer take and the expiration date hasn’t passed, help others who need them.