Legislation Will Interfere With Cancer Drug Payment Assistance

In Breast Cancer, Recent Posts by Barbara Jacoby

For any cancer patient, there is a great likelihood that somewhere in your treatment, a drug will be included. For those with insurance, the cost for such drugs may come with a small or perhaps even no co-payment. But for those who do not have prescription coverage or have a high co-payment, drug coverage would not be affordable if it were not for the drug discount coupons and manufacturer’s co-payment programs that make the drugs affordable to the patients. However, in a new twist that is currently being considered by the legislature in California, these programs would not be available in those cases where a lower cost brand name or non-brand name prescription drug is available.

And regardless of where you live, all patients need to stay vigilant in order to advocate for themselves so that legislation does not keep you from being able to afford whatever prescription medication you may need.Barbara Jacoby

The main part of the bill titled “AB 265” reads as follows:

“This bill would expand the law to prohibit, except as provided, a person who manufactures a prescription drug from offering in California any discount, rebate, product voucher, or other reduction in an individual’s out-of-pocket expenses, including, but not limited to, a copayment or deductible, for any prescription drug if a lower cost brand name or nonbrand name prescription drug is available that is designated by the United States Food and Drug Administration as therapeutically equivalent to, or interchangeable with, the prescription drug manufactured by that person.”

While I believe that I understand that the goal is to reduce costs by moving patients to lower cost medications such as generic medications or what are called biosimilar medications, this is a potentially dangerous practice for patients. This legislation would not only apply to cancer medications but also to any medications that a medical professional would prescribe for any medical condition. But, I would like to share my own experience in order to explain how this type of regulation can be harmful to an individual.

Following my second breast cancer surgery, I began a five-year course of hormone therapy with the brand name drug, Femara. At the end of four years, I was switched to the generic brand of the drug, Letrozole. When I started the Letrozole, I did confirm that it was a change that had the approval of my medical doctor so I never gave it another thought. Just a couple of weeks later, I started experiencing excruciating pain in my hip joints when I walked for just a couple of minutes. I would have to sit down for a minute or so before being able to continue on my way. I thought that perhaps this was the beginning of arthritis or some other joint disease that had manifested itself. So I started to research the side effects of Letrozole, only to learn that joint pain is one of them. And amazing to me was the fact that joint pain is also a side effect of Femara. So I decided to stop taking the Letrozole and lo, and behold, the hip pain disappeared.

What I learned is that although brand name and generic drugs have the same basic ingredients, they are not exactly the same. I was also reminded that each of us is unique and what works for one person may not work for another. In fact, upon further investigation I encountered others who experienced severe joint pain while taking the name brand drug and did not have a similar experience on the generic option.

Please know that I am the first person who appreciates the ability to save money on any medication that I need to have. For me, even though I had prescription insurance for my medication, my co-payment for the brand name was so much higher than the co-pay for the generic brand. But, I was not a candidate for the generic brand and had I been forced to take the generic brand, I would have stopped taking my medication as many patients often do under such circumstances.

Therefore, I believe that government legislation should not control the assignment of prescription medications in this manner nor prohibit a patient from being able to afford medication when a brand name is their best and possibly only viable option. The prescribing of any medication needs to be solely in the hands of the medical professional who is ordering the prescription. This is the person who can monitor the patient’s experience on a medication and make changes as necessary when there are adverse side effects. Such a ruling is not and will never be in the best interest of any patient and could potentially be life threatening.

If you are a California resident and have interest in this matter, I have added here for your convenience, a draft letter from the California Chronic Care Coalition that addresses this issue with the Chairman, Assembly Health Committee. And regardless of where you live, all patients need to stay vigilant in order to advocate for themselves so that legislation does not keep you from being able to afford whatever prescription medication you may need.

Barbara Jacoby is an award winning blogger that has contributed her writings to multiple online publications that have touched readers worldwide.