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Color Us Surprised: Pharmacy Chain Owner AHF Opposes Calif. Mail-Order Drug Bill AB 2418

Calling it “a short-sighted and potentially dangerous piece of legislation that puts fattened wallets ahead of people’s lives” (does that rhetoric sound familiar, adult industry?), AHF dictator Michael Weinstein is on the attack to protect his territory.

Ironically, Assembly Bill 2418 will be heard by the California Senate Appropriations Committee on August 4 — the same day it will weigh AHF’s bill to criminalize adult production in the state, AB 1576.

Check out the fear mongering in AHF’s press release about AB 2418:

Mail-order delivery poses great threats to the health of those managing HIV/AIDS for many reasons:

  • It destroys the critical relationship between patients and the specialty pharmacists that know them personally, including their medical history and any issues that may impact medication adherence; the pharmacist will call if the client misses a refill as well as be available to provide the patient with education and support. Additionally, pharmacists lose the opportunity to check on the well being of their patients every month when they come in to pick up refills—a vital safety net and stopgap to catch any life-threatening situations a patient may face.

  • Without the routine check-ins with medical professionals, patients face a higher risk of poor adherence to medication. Missing or incorrectly administering doses of potent medications to treat these serious conditions can have dire effects on patients. Since each patient’s HIV management is slightly unique, consumers left to simply manage themselves without pharmacy support face the risk of their HIV becoming resistant to their current regimen, forcing them onto an even more costly medical regimen, or worse, risking their lives.

  • Patients would be mailed bulk 90-day supplies of their medications through mail-order programs like the one AB 2418 would enact, leading clients to receive large quantities of medications that they can not use should they become resistant to the medications or their physicians change their medications prescriptions to a more effective regimen, thus wasting thousands of dollars worth of medications that can not be returned because they have been dispensed. California’s AIDS Drug Assistance Program (ADAP), the longest term supplier of HIV/AIDS medications, does not dispense more than 30 days worth of an HIV/AIDS drugs for this very reason. Quality of care must trump the convenience of the pharmacy benefit manager/insurance company. One of the top reasons for hospitalization is due to adverse reactions to medications taken either correctly or incorrectly. When patients have large stocks of medications at home due to discontinuance or change of medications by their physician and they have had a 3-month fill, there is frequent confusion about which drugs to take, which ones to stop, and what to do with the excess drugs that have been dispensed on the 90-day fill. Without a personal relationship with a pharmacist to discuss these issues with the patient, there is high risk for incorrect self-dosing, and inappropriate disposal.

  • Because clients can only apply the cost relief offer by federal AIDS Drugs Assistance Programs (ADAP) to 30-day medication supplies, the 90-day stock delivered to patients’ doors without their input is ineligible for this subsidy. This means that patients are prohibited from accessing federal support programs that were developed specifically to help them, and the high cost of drugs will ultimately fall on them and their employers or other payers of the patient’s insurance plan.

  • Mail-order prescription delivery also creates privacy issues for clients who may be living with people who do not know about their medical condition. Instead of discreetly picking up a prescription at their specialty pharmacy, the medications arrive at their home where they can be mistakenly or purposely intercepted by someone other than the patient.

  • Because mail-order delivery would force the medication to be shipped sometimes from across the country, the patient faces the risk of receiving medication that was not properly stored in transit (e.g. refrigerated at appropriate room temperature/humidity range) – and therefore potentially dangerous – as well as the risk of a missed dose if already-unreliable package delivery arrives late.

Here’s some information on AB 2418 not provided by AHF

Medication Adherence/ Synchronization

Introduced February 21, 2014

Description

Poor medication adherence is responsible for increased hospitalization and risk of death and approximately $290 billion in increased medical costs annually.  In response, California Assemblywoman Susan A. Bonilla introduced AB 2418, which sought to allow patients to opt out of mandatory mail order programs if they prefer to obtain their prescriptions from a pharmacy or clinic and streamline refill synchronizations to allow patients to pick up all of their prescriptions during one visit to the pharmacy.

As amended in the Assembly, AB 2418 would require insurers to allow insured patients to refill medications at a prorated amount in order to sync refills of multiple prescriptions.  In addition, insurers would be required to establish a process whereby insured patients may opt out of mail-order restrictions.

AB 2418 passed the Assembly on May 29, 2014, and awaited commitee assignment in the Senate as of June 10, 2014.

Key Dates:

May 29, 2014 — Passed Assembly (75 to 1)

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  • AHF's pharmacies account for the bulk of its $200 million dollar yearly income that pays Weinstein his $600,000 plus benefits. The idea that patients might become independent consumers with various choices is as anathema to AHF as bare-back porn and Truvada - and for exactly the same reasons. It's always about the money with these guys. Their excuses for opposing this legislation are particularly weak and their motives singularly obvious.

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