California families are struggling to afford the cost of their healthcare and many are being forced to make tough decisions about whether to take their medications or pay for rent, food, or other day-to-day expenses.
A bill currently on the governor’s desk would make things worse by limiting access to critical coupons — assistance that could mean the difference between life and death for vulnerable patients.
Assembly Bill 265 would ban patients in California from receiving copayment assistance from a manufacturer copay or coupon card when an interchangeable generic medication is available at a lower cost.
Generic medications, which represent almost 90% of pharmacy transactions, provide a cost-effective alternative for many patients. However, for some patients, a generic medication simply will not work.
Forcing these patients to switch to the lowest-cost medication without regard to their individual health or circumstances will put a patient’s safety at risk and potentially add additional healthcare costs due to non-adherence complications and medication errors.
Many Californians do not realize that the entities benefiting most from the lower costs are pharmacy benefit managers and other payers who are often financially incentivized to dispense the lowest-cost medications to patients.
Recent changes in insurance design and higher cost-sharing for prescription medications have led to increased financial burden for many patients. In addition, it is becoming increasingly common for patients to have to meet a deductible, often quite high, before any prescription medication coverage applies.
Manufacturer copayment assistance programs are a solution to ensuring that patients have access to and pay the lowest cost for needed prescription medications to keep them healthy and productive. They are a valuable resource for many patients.
I urge Gov. Jerry Brown to veto AB 265, which will harm access to essential treatments for patients and further burden California families who are already struggling with the rising cost of healthcare.
DR. GUSTAVO ALVA is a psychiatrist based in Costa Mesa.