Pending Legislation Pertaining to Affordable Prescription Drug Coverage

In Breast Cancer, Creating Happiness, Recent Posts by Barbara Jacoby

In my continuing mission as a patient advocate, I include in my daily news review any information that I may find that deals with financial matters pertaining to cancer patient treatments. The purpose is to alert patients and medical professionals to information that may be of potential help in dealing with this most important aspect that affects a person’s treatment.

No one should ever have to be excluded from a prescription treatment that is being recommended by their medical professional because of financial considerations.Barbara Jacoby

This has become even more important in the last few years with so much information available everywhere and less time available to sift through it all in order to find what one needs. Therefore, I found that it was extremely important to share some information regarding pending legislation when I came across the following regarding a current bill in the CA Senate, known as SB1021, that includes its quoted “Summary” below:


“SB 1021 will protect prescription drug users by eliminating the sunset date on provisions of AB 339 (Gordon, 2015). The relevant provisions cap copays on a monthly supply of any prescription drug at $250 and prevent health plans from placing drugs in more expensive “tiers” based on the cost of purchase from the manufacturer alone. This legislation will also add preventive treatments to the definition of the AIDS drug cocktail, codify an existing regulation capping copays at the drug’s retail price, and limit drug formularies (lists of drugs offered) to four pricing tiers.”

For all cancer patients, or any patient receiving treatment from prescription drugs, this is a most important piece of legislation. Without it, there might not be a cap on the maximum amount of a co-pay on a monthly prescription resulting in the patient not being able to afford their prescription for treatment. And for most patients who may already be financially challenged in other areas of their lives after a cancer diagnosis or any other medical condition, many may opt out of this part of their treatment if it becomes unaffordable.

I strongly suggest that you review this Fact Sheet and then contact your local legislator with a request to vote for this bill. And although this legislation is a CA bill, you may want to check on what is going on in your own State’s legislature since patient advocacy is now more important than ever. Patients need to become involved when legislation is hurting/hindering their opportunities for treatment.

And if you find yourself in a position where you can’t even afford your co-pay, you might want to contact the pharmaceutical company that manufactures your prescription drug to find out whether you qualify for prescription assistance from one of their own patient-assistance programs. No one should ever have to be excluded from a prescription treatment that is being recommended by their medical professional because of financial considerations.

If this becomes a consideration for you, you may want to alert your medical team to find out whether they have recommendations for you based upon their past experiences. Or you may want to research other organizations that provide assistance to others who are dealing with their same conditions such as breast cancer. If they can’t help you directly, they most likely can refer you to another resource for assistance. My greatest hope is that if you are having financial difficulties in paying for your portion of this treatment that you won’t choose to just stop your medication even if it may take a bit of work on your part to find help. After all, your medications have been prescribed as a very important part of your treatment and your future health conditions and should not just be randomly dismissed or eliminated under any circumstances.