Saturday, November 28, 2020

RE-ACCESSING UNUSED CANCER DRUG$ - A COST-CONSCIOUS INITIATIVE

"FACT: CANCER DRUGS ARE VERY EXPENSIVE AND NOT EVERYONE CAN AFFORD THEM! Just check out some price tags in this link @ GOODRX.com"

NYCRA News connected with Mr. Kirby Lewis, a 2x cancer victim and a survivor-crusader.  He and a handful of community leaders are framing a grassroots outreach program to explore new solutions to making cancer drugs accessible and affordable. "I came from a family that did not believe in hording, excess or wasting anything useful.  This is why it hurts to see my massive stockpile of unused cancer drugs from my episodes of treatment under the bathroom sink.  When I think about so many people out there who truly need and cannot afford any of this, I am compelled to find a way to save those lives through the redistribution of these meds.  I'd like to add that as a military vet, I am blessed with benefits to acquire my treatments and these drugs at no charge or a much reduced charge than most- where some of these doses cost in excess of $20-30,000 a shot."

Aptly called THE KIRBY PROJECT, Kirby's initiative speaks for the countless cancer patients in this country that do not have his type of medical support.  He added, "Insurance never covers everything- especially when it comes to drastic cases like cancer. If you're lucky, most insurance covers 50% - or even at the very best, 90% - and a vial of chemo that might be $20,000 you still have to pay a balance or a copay that can easily wipe your family out!" 

From his recent collaborative discussion with MBCC president Cheri Ambrose, references of drug prices and insurance coverage caps where heavily referenced to launch this point. "If you think about a range of drugs that cost anywhere between $71,000 to $27,000 for a 30-day supply, no insurance company would enjoy covering such a bill and chances are, they won't.  Carriers have been bankrupted, have DROPPED patients for situations like this or have simply rejected claims for this brand, replacing it with a lower cost (and possibly not as effective) alternative", states Ambrose.  


Diagram (L)- courtesy of goodrx.com/ data & report by: Lauren Chase & GoodRx research team -(8/11/2020). In an effort to continue to shed light on drug prices and increase transparency, the GoodRx Research Team regularly tracks the most expensive drugs in the U.S. Since 2018, we have tracked the list price and dosing requirements to identify the most expensive drugs. Here we look at the most expensive drugs that patients can get at a pharmacy and administer themselves. This list does not include medications that must be administered by a healthcare practitioner. In March, the GoodRx Research team put together the list of the most expensive drugs including those that must be administered by a medical professional. 

 See complete article.


According to recent NIH reports, pharmaceutical donation and reuse programs are distinct prescription drug programs providing for unused prescription drugs to be donated and re-dispensed to patients since 1997. -- but the operative term here is UNUSED. Once a drug touches the home and the hands of a consumer, the value, safety and guarantee of that drug for its intended function DISAPPEARS (see complete details below/ Plan B)


THE KIRBY PROJECT:
 
UNITING TO RESOLVE THE DEADLY PRICE TAG OF CANCER MEDS

According to a report from the NIH, "the cost of cancer care is the most rapidly increasing component of U.S. health care spending and will increase from $125 billion in 2010 to an estimated $158 billion in 2020, a 27% increase. 

Recently, first started a discussion with a handful of cancer survivors and org leaders from the NY Cancer Resource Alliance and Dr. Robert Bard (CancerScan Center) who were very supportive of my idea and were willing to help me convert this into a real initiative.  Before I knew, it, more and more people joined in to brainstorm about how to appeal to the pharma companies and (hopefully) discover the WIN-WIN together.  We looked into the many legal parameters and even searched for the right legislators to help build an awareness platform that might help leverage change from the top down.  It was clear that we were going to need a lot more friends to make a dent at this.  A sensible first base was to connect with all the community groups and cancer foundation leaders or anyone in a leadership role who recognizes this economic dilemma and "the real price of cancer". 

WHY CAN'T WE REUSE EXPENSIVE (UNUSED) DRUGS?
In a series of panel discussions to explore opportunities to address the astronomical cost of cancer medication, we kept returning to a plan of SUSTAINABILITY.  We explored the policy of re-purposing, re-selling or donating what is commonly identified as USED, UNWANTED or SURPLUS DRUGS.  

https://www.pbs.org/newshour/health/tylenol-murders-1982 

While carrying tremendous merit, in accordance with laws about recycling drugs, this concept in its raw form violates various public safety guidelines.  ANY drug that has left the authorized distributor and whose seal is broken are called this, hold a tremendous liability for safety, leaving open to massive potential lawsuits from the manufacturer, the distributor and the prior owner- should any issues/side effects or injury occur upon re-use. (source: https://www.ncsl.org/research/health/state-prescription-drug-return-reuse-and-recycling.aspx)

PLAN B:  According to the NSCL (National Conference of State Legislatures),  pharmaceutical companies are able to subscribe to the national Pharmaceutical Donation and Reuse Programs - providing unused prescription drugs to be donated and re-dispensed to patients. Since 1997, 38 states have participated in this program. (See complete NSCL news). Safety restrictions carry strict guidelines as to who can donate and what types of prescription products may be donated.  


QUESTIONING HIGH-COST DRUGS

Excerpted from "The Cost of Oncology Drugs: A Pharmacy Perspective, Part I"

"Health care costs are the fastest growing financial segment of the U.S. economy. The Centers for Medicare and Medicaid Services (CMS) estimates health care spending in the U.S. will increase from $3.0 trillion in 2014 to $5.4 trillion by 2024.1 About 19.3% of the U.S. gross domestic product is consumed by health care, which is twice that of any other country in the world. It is often stated that the increasing cost of health care is the most significant financial threat to the U.S. economy. The cost of medications, including those for treating cancer, is the leading cause of increased health care spending."

See this complete report on NIH/PubMed




VIEWPOINTS: FROM THE PROS

Robert L. Bard, MD, PC, DABR, FASLMS
Like Kirby, I am a former military physician with global experience in pharmaceutical kinetics.  We have long known that the effective life of many medications extends months and possibly years after the expiration date (artificially mandated by governmental agencies).  With copycats [from other countries], faulty manufacturing practices or careless packaging, many products found on the market are either ineffective or harmful.  An example, I recently learned about foreign copycats are drug formulas that have been stolen and replaced - like “hair crème” being passed off as penicillin at some US bases. Prices in the US or overseas facilities are significantly higher than in most hosting nations. While initial cost of creation and FDA acceptance is staggering, so is the payback of a successful launch for such drugs as anticholesterol agents. One must recognize that individual tolerance and therapeutic delivery vary greatly so a personal validation of the treatment is useful.  Many “cures” may kill the disease but devastate the patient as well in the process, both economically and healthwise.  Caveat emptor- make sure it works and investigate the side effects.

Cheri Ambrose
(President, Male Breast Cancer Coalition)
I hear from survivors all the time who have lost their jobs, their homes, and in some cases their families while navigating a cancer journey. The stress of the diagnosis and treatment alone can be insurmountable.  Add to that the startling cost of drugs needed to fight the disease and you have the makings of a Perfect Storm.   Patients should never have to make the decision to choose between putting food on their table or treating their disease.  Pharmaceutical companies can and should do more to help those uninsured, underinsured, or otherwise financially stressed patients.  I also feel the Insurance industry should do more to ease the burden of cost on patients being treated for cancer. After all, people don't choose cancer, Cancer chooses them. 








MICHAEL'S CHOICE:
A Different End-of-Life Plan
By: Lorraine S. Davi (San Francisco, CA)

Every cancer advocate carries a story that inspired their personal mission to help others.  A rare and compelling one is about accepting and surviving the passing of a cancer victim who chose the uncommon path of facing their fate and living the rest of his days without any cancer-fighting treatment.










MORE:

1) https://canceradvocacy.org/kirby-lewis-cpat-symposium-hill-day-experience/

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